Cangrelor in ST-Elevation Myocardial Infarction to Decrease Infarct Size
| Status: | Recruiting |
|---|---|
| Conditions: | Cardiology |
| Therapuetic Areas: | Cardiology / Vascular Diseases |
| Healthy: | No |
| Age Range: | 18 - 99 |
| Updated: | 3/20/2019 |
| Start Date: | January 2017 |
| End Date: | December 2019 |
| Contact: | Khaled Ziada, MD |
| Email: | kziad2@uky.edu |
Periprocedural Cangrelor in Patients With ST-Elevation Myocardial Infarction to Reduce Development of Myocardial Necrosis
This study evaluates differences in the extent of myocardial necrosis noted by cardiac MRI in
patients with ST-elevation myocardial infarction randomized to receive cangrelor during their
percutaneous coronary intervention and compares them to patients randomized to not receive
cangrelor.
patients with ST-elevation myocardial infarction randomized to receive cangrelor during their
percutaneous coronary intervention and compares them to patients randomized to not receive
cangrelor.
Cangrelor is a direct-acting and reversible intravenously administered platelet inhibitor
approved as an adjunct to percutaneous intervention (PCI) for reducing the risk of
periprocedural myocardial infarction, repeat coronary revascularization, and stent
thrombosis. As it has a quick onset of action (2 minutes) compared to traditional oral
platelet inhibitors, cangrelor is emerging as an important new option for use in patients
undergoing percutaneous intervention who have not been treated with oral platelet inhibitors.
Furthermore, multiple studies have demonstrated that patients with ST-elevation myocardial
infarction (STEMI) who undergo emergent PCI do not have optimal platelet inhibition even
after administration of a loading dose of traditional oral platelet inhibitors. However, the
clinical significance of complete platelet inhibition around the time of PCI is not fully
understood.
The primary objective is to characterize the utility of immediate platelet inhibition with
intravenous cangrelor in patients presenting with an acute STEMI by assessing the extent of
infarct size (either enzymatically or by imaging). If the findings are favorable, this may
suggest that immediate platelet inhibition is an important part of care in this patient
population.
approved as an adjunct to percutaneous intervention (PCI) for reducing the risk of
periprocedural myocardial infarction, repeat coronary revascularization, and stent
thrombosis. As it has a quick onset of action (2 minutes) compared to traditional oral
platelet inhibitors, cangrelor is emerging as an important new option for use in patients
undergoing percutaneous intervention who have not been treated with oral platelet inhibitors.
Furthermore, multiple studies have demonstrated that patients with ST-elevation myocardial
infarction (STEMI) who undergo emergent PCI do not have optimal platelet inhibition even
after administration of a loading dose of traditional oral platelet inhibitors. However, the
clinical significance of complete platelet inhibition around the time of PCI is not fully
understood.
The primary objective is to characterize the utility of immediate platelet inhibition with
intravenous cangrelor in patients presenting with an acute STEMI by assessing the extent of
infarct size (either enzymatically or by imaging). If the findings are favorable, this may
suggest that immediate platelet inhibition is an important part of care in this patient
population.
Inclusion Criteria:
- Patients with an acute STEMI with the University of Kentucky as the institution of
presentation with plans for PCI
- English-speaking
Exclusion Criteria:
- Pregnant patients
- Prisoners
- Patients who are unable to provide his/her own consent
- Patients with a prior history of myocardial infarction
- Patients who have received thrombolytics
- Patients on systemic anticoagulation
- Patients who are hemodynamically unstable with evidence of shock
- Patients who are mechanically intubated
- Patients with devices not MRI compatible
- Patients with chronic kidney disease, glomerular filtration rate less than 30
- Patients who are already on dual antiplatelet therapy
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