Phenotyping the Use of Cangrelor in Percutaneous Coronary Interventions

The use of antiplatelet agents is essential in percutaneous coronary interventions, both periprocedurally and in the post-interventional period. Procedural antiplatelet therapy, aiming to limit ischemic complications, is mostly administered with oral agents, including aspirin and P2Y12 inhibitors. H...

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Main Authors: Nikolaos Pyrpyris, Kyriakos Dimitriadis, Konstantinos G. Kyriakoulis, Stergios Soulaidopoulos, Panagiotis Tsioufis, Aggelos Papanikolaou, Nikolaos G. Baikoussis, Alexios Antonopoulos, Konstantinos Aznaouridis, Konstantinos Tsioufis
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Language:English
Published: MDPI AG 2025-03-01
Series:Pharmaceuticals
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Online Access:https://www.mdpi.com/1424-8247/18/3/432
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author Nikolaos Pyrpyris
Kyriakos Dimitriadis
Konstantinos G. Kyriakoulis
Stergios Soulaidopoulos
Panagiotis Tsioufis
Aggelos Papanikolaou
Nikolaos G. Baikoussis
Alexios Antonopoulos
Konstantinos Aznaouridis
Konstantinos Tsioufis
author_facet Nikolaos Pyrpyris
Kyriakos Dimitriadis
Konstantinos G. Kyriakoulis
Stergios Soulaidopoulos
Panagiotis Tsioufis
Aggelos Papanikolaou
Nikolaos G. Baikoussis
Alexios Antonopoulos
Konstantinos Aznaouridis
Konstantinos Tsioufis
author_sort Nikolaos Pyrpyris
collection DOAJ
description The use of antiplatelet agents is essential in percutaneous coronary interventions, both periprocedurally and in the post-interventional period. Procedural antiplatelet therapy, aiming to limit ischemic complications, is mostly administered with oral agents, including aspirin and P2Y12 inhibitors. However, there are several limitations in the use of oral P2Y12 inhibitors, including their difficult administration in patients presenting with cardiogenic shock and their relatively slower onset of action, leaving a significant period of the procedure with a suboptimal antiplatelet effect. These pitfalls could be avoided with the use of cangrelor, the only available intravenous P2Y12 inhibitor, which has a rapid onset and offset antiplatelet effect, as well as a favorable pharmacological profile. The use of cangrelor has been increasing in recent years, with several studies aiming to determine what the optimal patient phenotype to receive such treatment ultimately is and how its use could be adjunctive to oral P2Y12 inhibitors. Therefore, the aim of this review is to provide an overview of the pharmacological profile of cangrelor and an update regarding the clinical evidence supporting its use, as well as to discuss the optimal patient phenotype, related clinical algorithms, and future implications for larger implementation of this agent into everyday clinical practice.
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spelling doaj-art-ca58831386dc48c8acc69a1459fbffa62025-08-20T03:43:29ZengMDPI AGPharmaceuticals1424-82472025-03-0118343210.3390/ph18030432Phenotyping the Use of Cangrelor in Percutaneous Coronary InterventionsNikolaos Pyrpyris0Kyriakos Dimitriadis1Konstantinos G. Kyriakoulis2Stergios Soulaidopoulos3Panagiotis Tsioufis4Aggelos Papanikolaou5Nikolaos G. Baikoussis6Alexios Antonopoulos7Konstantinos Aznaouridis8Konstantinos Tsioufis9First Department of Cardiology, School of Medicine, National and Kapodistrian University of Athens, Hippokration General Hospital, 115 27 Athens, GreeceFirst Department of Cardiology, School of Medicine, National and Kapodistrian University of Athens, Hippokration General Hospital, 115 27 Athens, GreeceFirst Department of Cardiology, School of Medicine, National and Kapodistrian University of Athens, Hippokration General Hospital, 115 27 Athens, GreeceFirst Department of Cardiology, School of Medicine, National and Kapodistrian University of Athens, Hippokration General Hospital, 115 27 Athens, GreeceFirst Department of Cardiology, School of Medicine, National and Kapodistrian University of Athens, Hippokration General Hospital, 115 27 Athens, GreeceFirst Department of Cardiology, School of Medicine, National and Kapodistrian University of Athens, Hippokration General Hospital, 115 27 Athens, GreeceDepartment of Cardiac Surgery, Hippokration General Hospital, 115 27 Athens, GreeceFirst Department of Cardiology, School of Medicine, National and Kapodistrian University of Athens, Hippokration General Hospital, 115 27 Athens, GreeceFirst Department of Cardiology, School of Medicine, National and Kapodistrian University of Athens, Hippokration General Hospital, 115 27 Athens, GreeceFirst Department of Cardiology, School of Medicine, National and Kapodistrian University of Athens, Hippokration General Hospital, 115 27 Athens, GreeceThe use of antiplatelet agents is essential in percutaneous coronary interventions, both periprocedurally and in the post-interventional period. Procedural antiplatelet therapy, aiming to limit ischemic complications, is mostly administered with oral agents, including aspirin and P2Y12 inhibitors. However, there are several limitations in the use of oral P2Y12 inhibitors, including their difficult administration in patients presenting with cardiogenic shock and their relatively slower onset of action, leaving a significant period of the procedure with a suboptimal antiplatelet effect. These pitfalls could be avoided with the use of cangrelor, the only available intravenous P2Y12 inhibitor, which has a rapid onset and offset antiplatelet effect, as well as a favorable pharmacological profile. The use of cangrelor has been increasing in recent years, with several studies aiming to determine what the optimal patient phenotype to receive such treatment ultimately is and how its use could be adjunctive to oral P2Y12 inhibitors. Therefore, the aim of this review is to provide an overview of the pharmacological profile of cangrelor and an update regarding the clinical evidence supporting its use, as well as to discuss the optimal patient phenotype, related clinical algorithms, and future implications for larger implementation of this agent into everyday clinical practice.https://www.mdpi.com/1424-8247/18/3/432cangrelorantiplateletpercutaneous coronary interventioncardiogenic shockmicrocirculationcoronary artery disease
spellingShingle Nikolaos Pyrpyris
Kyriakos Dimitriadis
Konstantinos G. Kyriakoulis
Stergios Soulaidopoulos
Panagiotis Tsioufis
Aggelos Papanikolaou
Nikolaos G. Baikoussis
Alexios Antonopoulos
Konstantinos Aznaouridis
Konstantinos Tsioufis
Phenotyping the Use of Cangrelor in Percutaneous Coronary Interventions
Pharmaceuticals
cangrelor
antiplatelet
percutaneous coronary intervention
cardiogenic shock
microcirculation
coronary artery disease
title Phenotyping the Use of Cangrelor in Percutaneous Coronary Interventions
title_full Phenotyping the Use of Cangrelor in Percutaneous Coronary Interventions
title_fullStr Phenotyping the Use of Cangrelor in Percutaneous Coronary Interventions
title_full_unstemmed Phenotyping the Use of Cangrelor in Percutaneous Coronary Interventions
title_short Phenotyping the Use of Cangrelor in Percutaneous Coronary Interventions
title_sort phenotyping the use of cangrelor in percutaneous coronary interventions
topic cangrelor
antiplatelet
percutaneous coronary intervention
cardiogenic shock
microcirculation
coronary artery disease
url https://www.mdpi.com/1424-8247/18/3/432
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