Citation: American Journal of Cardiology. 123(8):1228-1238, 2019 04 15.; .Journal: The American journal of cardiology.Published: 2019; ; ISSN: 0002-9149.Full author list: Beyene S; Brathwaite E; Buchanan K; Dan K; Dheendsa A; Gajanana D; Garcia-Garcia HM; Hideo-Kajita A; Iantorno M; Kolm P; Meirovich Y; Melaku G; Ozaki Y; Rogers T; Torguson R; Waksman R.UI/PMID: 30738570.Subject(s): *Adenosine Monophosphate/aa [Analogs & Derivatives] | *Coronary Thrombosis/th [Therapy] | *Percutaneous Coronary Intervention/mt [Methods] | Adenosine Monophosphate/tu [Therapeutic Use] | Aged | Coronary Angiography | Coronary Thrombosis/di [Diagnosis] | Female | Follow-Up Studies | Humans | Male | Middle Aged | Purinergic P2Y Receptor Antagonists/tu [Therapeutic Use] | Retrospective Studies | Treatment OutcomeInstitution(s): MedStar Heart & Vascular Institute | MedStar Washington Hospital CenterActivity type: Journal Article.Medline article type(s): Journal ArticleDigital Object Identifier: https://dx.doi.org/10.1016/j.amjcard.2019.01.031 (Click here)Abbreviated citation: Am J Cardiol. 123(8):1228-1238, 2019 04 15; .Local Holdings: Available online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - 2006.Abstract: Copyright (c) 2019. Published by Elsevier Inc.Abstract: Percutaneous coronary intervention (PCI) in patients with angiographic evidence of intracoronary thrombus is associated with in-hospital and 30-day adverse clinical outcomes. Cangrelor, a direct, rapid-onset acting intravenous P2Y<sub>12</sub> receptor inhibitor, has been proved to be effective by reducing peri-PCI ischemic complications in subjects who underwent PCI. This study aimed to assess the angiographic and in-hospital clinical outcomes in all-comer patients receiving cangrelor immediately before PCI at a tertiary care center. The study analyzed consecutive unselected subjects treated with cangrelor at the time the decision was made to proceed with PCI. At the end of the procedure, all patients were transitioned to oral antiplatelet therapy. The target lesion angiographic assessment of Thrombolysis in myocardial infarction flow grade (TIMI-Flow), TIMI-thrombus grade (TIMI-Thrombus), myocardial blush grade, and TIMI-myocardial perfusion grade (TMPG) was performed before and post-PCI. Clinical events were recorded during the procedure and at discharge. In total, 223 patients (244 lesions) were included in the analysis (106, 97, and 20 patientswith TIMI-Flow 0/1, TIMI-Flow 2/3, and cardiogenic shock, respectively). The overall mean age was 63 +/- 12 years, 70% men and 38% with diabetes mellitus. Acute myocardial infarction was the main presentation (72%). The use of cangrelor improved TIMI-Flow, MGB, TMPG, and TIMI-Thrombus in patients with initial TIMI-Flow 0 to 2. Major bleeding rate was 2.0%. In conclusion, cangrelor was effective and safe in restoring TIMI-Flow 3, reducing thrombus burden and improving myocardial blush grade and TMPG when administered to unselected subjects who underwent PCI. Therefore, cangrelor should be considered in patients presenting with intracoronary thrombus before intervention.