cangrelor (Kengreal)

^[1]^[2]^[3]^[4]

Introduction

Investigational intravenous agent. FDA approval recommended^[3]

platelet inhibition in association with PCI; no better than clopidogrel for patients undergoing PCI for acute coronary syndromes^[1]

30 ug/kg bolus & 4 ug/kg infusion followed by 600 mg of clopidogrel at termination of infusion^[2]
continue with aspirin 81 mg QD + clopidogrel 75 mg QD

rapid onset of action (more rapid than clopidogrel)
short half-life that allows normalization of platelet function within 60 minutes of discontinuation

↑ ^1.0 ^1.1 Harrington RA et al Platelet inhibition with cangrelor in patients undergoing PCI. N Engl J Med. 2009 Dec 10;361(24):2318-29. Epub . <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/19915221 <Internet> http://dx.doi.org/10.1056/NEJMoa0908628
Kastrati A and Ndrepepa G. Cangrelor - A champion lost in translation? N Engl J Med. 2009 Dec 10;361(24):2382-4 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/19915223 <Internet> http://dx.doi.org/10.1056/NEJMe0910677
↑ ^2.0 ^2.1 Bhatt DL et al. Effect of platelet inhibition with cangrelor during PCI on ischemic events. N Engl J Med 2013 Mar 10 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/23473369 <Internet> http://www.nejm.org/doi/full/10.1056/NEJMoa1300815
Lange RA and Hillis LD. The duel between dual antiplatelet therapies. N Engl J Med 2013 Mar 10 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/23473370 <Internet> http://www.nejm.org/doi/full/10.1056/NEJMe1302504
↑ ^3.0 ^3.1 Hustin L, Chavey WE Cangrelor Finally Gets Nod from FDA Advisory Panel. Physician's First Watch, April 17, 2015 David G. Fairchild, MD, MPH, Editor-in-Chief Massachusetts Medical Society http://www.jwatch.org
↑ ^4.0 ^4.1 ^4.2 FDA News Release. June 22, 2015 FDA approves new antiplatelet drug used during heart procedure. http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm452172.htm