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Abstract

Aims

The present analysis of the ARCANGELO study aims to investigate the effect of switching to different oral P2Y inhibitors when using cangrelor during PCIs in patients with ACS.

Methods

Out of the 995 patients meeting the criteria for this investigation, 138 transitioned to Clopidogrel (CLO), 127 to prasugrel (PRA), and 730 to Ticagrelor (TICA). Compared to the patients on PRA or TICA, users of CLO were older (median (Q1-Q3) 74(64-81) years CLO, 59(54-65) years PRA, 65(56-73) TICA; p<0.0001), had more comorbidities (37.0% CLO, 17.3% PRA, 18.9% TICA, p<0.0001), and had more frequently an NSTEMI diagnosis (68.1% CLO 33.1% PRA 35.9% TICA, p<0.0001).

Results

Five moderate bleedings were recorded without any severe episodes. There were no significant differences in the bleeding rate when switching to the different oral P2Y inhibitors (2.2% CLO, 5.3% TICA, 7.9% PRA, p = 0.0705) while different incidences of MACEs (4.3% CLO, 1.1% TICA, 0% PRA, p = 0.0113) and NACEs (4.3% CLO, 1.8% TICA, 0% PRA, p=0.0321) were observed during the 30 days of the study.

Conclusion

The use of cangrelor and the switch to any oral P2Y inhibitor in compliance with the EU SmPC is safe, with a low risk of ischemic events in routine clinical practice.

© 2025 Bentham Science Publishers
© 2025 The Author(s). Published by Bentham Science Publisher. This is an open access article published under CC BY 4.0 https://creativecommons.org/licenses/by/4.0/legalcode
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2025-06-02
2025-09-05

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Transitioning from Cangrelor to Oral P2Y12 Inhibitors in Patients with ACS: Insights from the ARCANGELO Study
Bentham Science Publishers ; https://doi.org/10.2174/0115701611309982250522065849
/content/journals/cvp/10.2174/0115701611309982250522065849
/content/journals/cvp/10.2174/0115701611309982250522065849
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  • Article Type:     Research Article
Keywords: acute coronary syndrome ; PCI ; Cangrelor ; bleeding ; real-world evidence ; P2Y12 inhibitor

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