The intravenous, rapidly acting P2Y12 inhibitor cangrelor reduces the rate of ischemic events during PCI with no significant increase in severe bleeding. However, the efficacy and safety of cangrelor compared with clopidogrel in patients treated with single vessel (SV)‐percutaneous coronary intervention (PCI) or multivessel (MV)‐PCI remains unexplored.
We studied the modified intention‐to‐treat population of patients from the CHAMPION PHOENIX trial who were randomized to either cangrelor or clopidogrel. We used logistic regression and propensity score matching to evaluate the effect of cangrelor compared with clopidogrel on the primary efficacy outcome (composite of death, myocardial infarction, ischemia‐driven revascularization, or stent thrombosis) at 48 hours. The safety outcome was moderate or severe Global Utilization of Streptokinase and tPA for Occluded Arteries bleeding at 48 hours.
Among 10 854 patients, 9204 (85%) underwent SV‐ and 1650 (15%) MV‐PCI. After adjustment, cangrelor was associated with similar reductions vs clopidogrel in the primary efficacy outcome in patients undergoing SV‐PCI (4.5% vs 5.2%; odds ratio [OR] 0.81 [0.66‐0.98]) or MV‐PCI (6.1% vs 9.8%, OR 0.59 [0.41‐0.85]; Pint 0.14). Similar results were observed after propensity score matching (SV‐PCI: 5.5% vs 5.9%, OR 0.93 [0.74‐1.18]; MV‐PCI: 6.2% vs 8.9%, OR 0.67 [0.44‐1.01]; Pint 0.17). There was no evidence of heterogeneity in the treatment effect of cangrelor compared with clopidogrel for the safety outcome.