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Safety and Efficacy of Cangrelor in Acute Coronary Syndromes: A Systematic Review and Network Meta-Analysis

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Abstract

Introduction

Cangrelor is a potent intravenous non-thienopyridine P2Y12 inhibitor. We conducted a network meta-analysis to study the efficacy and safety of cangrelor as compared with the oral P2Y12 inhibition, clopidogrel, or placebo in acute coronary syndromes.

Methods

This meta-analysis followed the Cochrane collaboration guidelines and the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) protocols. Outcomes of interest included all-cause mortality, myocardial infarction, stent thrombosis, target vessel revascularization, major bleeding, minor bleeding, and the need for blood transfusion.

Results

The analysis was comprised of 6 studies including 26,444 patients treated with cangrelor, clopidogrel, or placebo. There were no statistically significant differences in the incidence of all-cause mortality, myocardial infarction, stent thrombosis, target vessel revascularization, or major bleeding. Cangrelor was associated with a higher risk of minor bleeding than clopidogrel or placebo, with no difference in requiring blood transfusion.

Conclusion

Cangrelor has comparable outcomes to clopidogrel in patients with acute coronary syndromes and can be used as a reliable alternative in this population.

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Author information

Authors and Affiliations

  1. Rochester Regional Health/Unity Hospital, Rochester, NY, USA

    Mostafa Reda Mostafa & Mohamed Magdi Eid

  2. Faculty of Medicine, Ain-Shams University, Cairo, Egypt

    Ahmed K. Awad

  3. Department of Medicine, Rochester General Hospital, Rochester, NY, USA

    Andrew Takla

  4. Faculty of Medicine, Tanta University, Tanta, Egypt

    Abdul Rhman Hassan, Basant E. Katamesh & Abdul Rhman Ziada

  5. Faculty of Medicine, Jordan University of Science and Technology, Amman, Jordan

    Majd M. AlBarakat

  6. Cairo university School of Medicine, Cairo, Egypt

    Sarah Mohamed

  7. Baylor Scott and White Health-The Heart Hospital, Plano, TX, USA

    Karim M. Al-Azizi

  8. Department of Cardiovascular Medicine, Baystate Medical Center, Springfield, MA, USA

    Andrew M. Goldsweig

  9. Division of Cardiovascular Medicine, University of Nebraska Medical Center, Omaha, NE, USA

    Andrew M. Goldsweig

Authors
  1. Mostafa Reda Mostafa
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Corresponding author

Correspondence to Mostafa Reda Mostafa.

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Conflict of interest

AM Goldsweig reports consulting fees from Philips and Inari and speaking fees from Philips and Edwards. MR Mostafa, MM Eid, AK Awad, A Takla, AR Hassan, BE Katamesh, MM AlBarakat, AR Ziada, S Mohamed, and KM Al-Azizi have no potential conflicts of interest that might be relevant to the contents of this manuscript.

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No external funding was used in preparation of this manuscript.

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Author contribution

MRM: conceptualization, screening, extraction, writing, and review and editing. MME: conceptualization and writing—original draft. AT: writing—original draft and writing—review and editing. AKA: analysis and writing. ARH, BEK, and MMA: literature review, screening, and data extraction. SM and ARZ: data extraction and quality assessment. KMA and AMG: conceptualization, writing, and review and editing.

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All the data generated or analyzed during this study are included in the published article.

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Mostafa, M.R., Eid, M.M., Awad, A.K. et al. Safety and Efficacy of Cangrelor in Acute Coronary Syndromes: A Systematic Review and Network Meta-Analysis. Am J Cardiovasc Drugs 24, 71–81 (2024). https://doi.org/10.1007/s40256-023-00616-2

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