000			04502nam a22007337a 4500
008			190314s20192019 xxu||||| |||| 00| 0 eng d
022			_a0002-9149
024			_a10.1016/j.amjcard.2019.01.031 [doi]
024			_aS0002-9149(19)30123-7 [pii]
040			_aOvid MEDLINE(R)
099			_a30738570
245			_aEffects of Cangrelor as Adjunct Therapy to Percutaneous Coronary Intervention.
251			_aAmerican Journal of Cardiology. 123(8):1228-1238, 2019 04 15.
252			_aAm J Cardiol. 123(8):1228-1238, 2019 04 15.
252			_zAm J Cardiol. 2019 Jan 25
253			_aThe American journal of cardiology
260			_c2019
260			_fFY2019
265			_saheadofprint
265			_sppublish
266			_d2019-03-14
268			_aAmerican Journal of Cardiology. 2019 Jan 25
501			_aAvailable online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - 2006
520			_aCopyright (c) 2019. Published by Elsevier Inc.
520			_aPercutaneous 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.
546			_aEnglish
650			_a*Adenosine Monophosphate/aa [Analogs & Derivatives]
650			_a*Coronary Thrombosis/th [Therapy]
650			_a*Percutaneous Coronary Intervention/mt [Methods]
650			_aAdenosine Monophosphate/tu [Therapeutic Use]
650			_aAged
650			_aCoronary Angiography
650			_aCoronary Thrombosis/di [Diagnosis]
650			_aFemale
650			_aFollow-Up Studies
650			_aHumans
650			_aMale
650			_aMiddle Aged
650			_aPurinergic P2Y Receptor Antagonists/tu [Therapeutic Use]
650			_aRetrospective Studies
650			_aTreatment Outcome
651			_aMedStar Heart & Vascular Institute
651			_aMedStar Washington Hospital Center
657			_aJournal Article
700			_aBeyene, Solomon
700			_aBrathwaite, Echo
700			_aBuchanan, Kyle
700			_aDan, Kazuhiro
700			_aDheendsa, Aaphtaab
700			_aGajanana, Deepakraj
700			_aGarcia-Garcia, Hector M
700			_aHideo-Kajita, Alexandre
700			_aIantorno, Micaela
700			_aKolm, Paul
700			_aMeirovich, Yael
700			_aMelaku, Gebremedhin
700			_aOzaki, Yuichi
700			_aRogers, Toby
700			_aTorguson, Rebecca
700			_aWaksman, Ron
790			_aBeyene 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
856			_uhttps://dx.doi.org/10.1016/j.amjcard.2019.01.031 _zhttps://dx.doi.org/10.1016/j.amjcard.2019.01.031
942			_cART _dArticle
999			_c4097 _d4097