Background. Reversible P2Y12 inhibition can be obtained with cangrelor administered intravenously. More experience with cangrelor use in acute PCI with unknown bleeding risk is needed. Objectives. To describe real-world use of cangrelor including patient and procedure characteristics and patient outcomes. Methods. We performed a single-centre, retrospective, and observational study including all patients treated with cangrelor in relation to percutaneous coronary intervention at Aarhus University Hospital during the years 2016, 2017, and 2018. We recorded procedure indication and priority, the indications for cangrelor use, and patient outcomes within the first 48 hours after initiation of cangrelor treatment. Results. We treated 991 patients with cangrelor in the study period. Of these, 869 (87.7%) had an acute procedure priority. Among acute procedures, patients were mainly treated for STEMI (n = 723) and the remaining were treated for cardiac arrest and acute heart failure. Use of oral P2Y12 inhibitors prior to percutaneous coronary intervention was rare. Fatal bleeding events (n = 6) were only observed among patients undergoing acute procedures. Stent thrombosis was observed in two patients receiving acute treatment for STEMI. Thus, cangrelor can be used in relation to PCI under acute circumstances with advantages in terms of clinical management. The benefits and risks, in terms of patient outcomes, should ideally be assessed in randomized trials.

中文翻译：

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坎格瑞洛辅助经皮冠状动脉介入治疗的真实经验：单中心观察性研究

背景。静脉注射坎格瑞洛可实现可逆性 P2Y12 抑制。需要更多坎格雷洛在出血风险未知的急性 PCI 中的使用经验。目标。描述坎格雷洛的实际使用情况，包括患者和手术特征以及患者结果。方法。我们进行了一项单中心、回顾性和观察性研究，包括 2016 年、2017 年和 2018 年在奥胡斯大学医院接受经皮冠状动脉介入治疗的所有接受坎格雷洛治疗的患者。我们记录了手术适应症和优先级、坎格雷洛使用的适应症，以及开始坎格雷洛治疗后 48 小时内的患者结果。结果。我们在研究期间使用坎格瑞洛治疗了 991 名患者。其中，869 例 (87.7%) 具有紧急手术优先权。在急性手术中，患者主要接受 STEMI 治疗（n  = 723），其余患者接受心脏骤停和急性心力衰竭治疗。在经皮冠状动脉介入治疗之前使用口服 P2Y12 抑制剂的情况很少见。 仅在接受急性手术的患者中观察到致命出血事件（n = 6）。两名接受 STEMI 急性治疗的患者观察到支架内血栓形成。因此，坎格瑞洛可用于急性情况下的 PCI，在临床管理方面具有优势。理想情况下，应通过随机试验评估患者结果方面的益处和风险。