Summary

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• Cangrelor (Kengreal) is indicated as an adjunct to percutaneous coronary intervention for reducing the risk of periprocedural myocardial infarction, repeat coronary revascularization, and stent thrombosis in patients who have not been treated with a P2Y12 platelet inhibitor and are not being given a glycoprotein IIb/IIIa inhibitor.
• Seven studies were reviewed, providing comprehensive information about Kengreal's safety and effectiveness compared to other drugs like clopidogrel, prasugrel, ticagrelor, particularly in the context of PCI.
• Compared to clopidogrel and other P2Y12 inhibitors such as prasugrel or ticagrelor, Kengreal significantly decreased the risk of composite adverse cardiovascular ischemic events. However, it was associated with higher incidence of major or any bleeding.
• In specific subgroups, such as patients with type 2 diabetes mellitus undergoing PCI or those requiring perioperative administration during surgery, Kengreal showed comparable efficacy but had increased risks related to mild GUSTO bleeding along with major & minor ACUITY bleeding.
• When used alongside endovascular therapy for stroke treatment, especially large-vessel occlusion strokes, Kengreal demonstrated a promising safety profile while also showing potential benefits beyond its current indications.
• Despite having significant advantages in reducing thrombotic events among patients undergoing PCI procedures, careful consideration should be taken due to its consistent association with increased bleeding risks, especially among vulnerable patient groups such as diabetics.