title: Cangrelor for the management and prevention of arterial thrombosis.
abstract: BACKGROUND
  Despite advances in antiplatelet therapy, the optimum antithrombotic regimen during percutaneous coronary intervention (PCI) remains to be determined. Cangrelor is an intravenous, reversibly-binding platelet P2Y12 receptor antagonist with ultra-rapid onset and offset of action that is approved in Europe and United States for use in patients undergoing PCI. This article describes the background for the development of cangrelor, the biology, pharmacology and clinical evidence supporting its use, and its likely position in the future.
  
  
  METHODS
  The role of the platelet P2Y12 receptor in platelet biology and the implications of this for atherothrombotic disease are described. Currently unmet needs in antithrombotic management during and after PCI are discussed followed by a description of the chemistry, pharmacokinetics and pharmacodynamics of cangrelor, including its interactions with oral thienopyridines. Subsequently, the clinical trial evidence supporting its adoption into clinical practice is reviewed, including the evidence indicating its superiority over a strategy based on clopidogrel treatment alone. Expert commentary: The current status and future potential of cangrelor is discussed, including a view of its place in current clinical practice.
authors.affiliation: a Department of Infection, Immunity and Cardiovascular Disease , University of Sheffield , Sheffield , UK.
authors.forename: Robert F
authors.initials: RF
authors.lastname: Storey
authors.affiliation: a Department of Infection, Immunity and Cardiovascular Disease , University of Sheffield , Sheffield , UK.
authors.forename: Akanksha
authors.initials: A
authors.lastname: Sinha
mesh_terms: D000249:Adenosine Monophosphate / Q000031:analogs & derivatives* / Q000627:therapeutic use; D061605:Administration, Intravenous; D000077144:Clopidogrel; D006801:Humans; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000379:methods; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D058921:Purinergic P2Y Receptor Antagonists / Q000627:therapeutic use; D013927:Thrombosis / Q000209:etiology / Q000517:prevention & control*; D013988:Ticlopidine / Q000031:analogs & derivatives / Q000627:therapeutic use
chemical_list: D010975:Platelet Aggregation Inhibitors; D058921:Purinergic P2Y Receptor Antagonists; D000249:Adenosine Monophosphate; C117446:cangrelor; D000077144:Clopidogrel; D013988:Ticlopidine
keywords: Cangrelor; P2Y12 receptor; arterial thrombosis; percutaneous coronary intervention; platelet receptor inhibitor; stent thrombosis