STEMI - ST Elevation Myocardial Infarction Clinical Trial
Official title:
Periprocedural Cangrelor in Patients With ST-Elevation Myocardial Infarction to Reduce Development of Myocardial Necrosis
This study evaluates differences in the extent of myocardial necrosis noted by cardiac MRI in patients with ST-elevation myocardial infarction randomized to receive cangrelor during their percutaneous coronary intervention and compares them to patients randomized to not receive cangrelor.
Cangrelor is a direct-acting and reversible intravenously administered platelet inhibitor
approved as an adjunct to percutaneous intervention (PCI) for reducing the risk of
periprocedural myocardial infarction, repeat coronary revascularization, and stent
thrombosis. As it has a quick onset of action (2 minutes) compared to traditional oral
platelet inhibitors, cangrelor is emerging as an important new option for use in patients
undergoing percutaneous intervention who have not been treated with oral platelet inhibitors.
Furthermore, multiple studies have demonstrated that patients with ST-elevation myocardial
infarction (STEMI) who undergo emergent PCI do not have optimal platelet inhibition even
after administration of a loading dose of traditional oral platelet inhibitors. However, the
clinical significance of complete platelet inhibition around the time of PCI is not fully
understood.
The primary objective is to characterize the utility of immediate platelet inhibition with
intravenous cangrelor in patients presenting with an acute STEMI by assessing the extent of
infarct size (either enzymatically or by imaging). If the findings are favorable, this may
suggest that immediate platelet inhibition is an important part of care in this patient
population.
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