Abstract

Will cangrelor become the favored agent for acute coronary syndrome treatment?

Author(s): M Ferlini, M Marino, LO Visconti & E Bramucci

Clopidogrel has been widely investigated, even if resistance limits its efficacy. Prasugrel and ticagrelor obtain a greater and homogeneous inhibition of platelet aggregation, but a delay onset of action in patients with stent thrombosis elevation myocardial infarction and an increased bleeding risk in case of surgical revascularization have been reported. Cangrelor is an intravenous reversible P2Y12 inhibitor with an immediate onset and a quick offset of action. Based on its pharmacokinetic and pharmacodynamic profile, and on clinical data, cangrelor could become the antiplatelet of choice in case of elective percutaneous coronary intervention without clopidogrel pretreatment and in acute coronary syndrome requiring urgent coronary angiography. However, in acute setting, data of comparison with prasugrel and ticagrelor are needed.