Cangrelor for the treatment of arterial thrombosis: pharmacokinetics/pharmacodynamics and clinical data.
BACKGROUND
Dual antiplatelet therapy is the standard of care for patients with acute coronary syndromes or with recent coronary stents implantation. P2Y12 receptor antagonists have shown to reduce the risk of recurrent ischemic events among these patients, at the expense of an increased risk of bleeding. Cangrelor is a novel, intravenous, short-acting, reversible platelet P2Y12 inhibitor, which has been evaluated for the treatment of arterial thrombosis.


METHODS
Studies on the pharmacological characteristics of cangrelor and clinical trials were retrieved by a PubMed literature search.


CONCLUSIONS
Cangrelor has been tested in patients with coronary artery diseases undergoing percutaneous coronary intervention and as bridging therapy for patients undergoing coronary artery bypass graft. The rapid peak of action allows a fast and complete inhibition of platelet aggregation; the rapid offset is advantageous in case of bleeding complications; and finally, the intravenous administration also makes this drug suitable for patients unable to consume oral medications. Unfortunately, the large clinical trials evaluating cangrelor in percutaneous coronary intervention did not show superiority to the standard antiplatelet therapy, and its future use in this setting still needs to be better assessed. Conversely, when used as bridging therapy to coronary artery bypass graft, cangrelor showed promising results.
University of Insubria, Research Center on Thromboembolic Disorders and Antithrombotic Therapies, Department of Clinical and Experimental Medicine , U.O. Medicina Interna 1, Ospedale di Circolo, viale Borri 57, 21100 Varese , Italy +39 0332 278831 ; +39 0332 278229 ; alessandro.squizzato@uninsubria.it.
Eleonora
E
Tamborini Permunian
Nicoletta
N
Riva
Luigina
L
Guasti
Alessandro
A
Squizzato
D000249:Adenosine Monophosphate / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000494:pharmacology / Q000627:therapeutic use; D003324:Coronary Artery Disease / Q000628:therapy; D006470:Hemorrhage / Q000139:chemically induced; D006801:Humans; D062645:Percutaneous Coronary Intervention / Q000379:methods; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D013927:Thrombosis / Q000188:drug therapy* / Q000473:pathology
D010975:Platelet Aggregation Inhibitors; D000249:Adenosine Monophosphate; C117446:cangrelor
P2Y12 inhibitor; acute coronary syndrome; cangrelor; percutaneous coronary intervention; pharmacodynamics; pharmacokinetics