# Efficacy and safety of cangrelor in patients with peripheral artery disease undergoing percutaneous coronary intervention – Insights from the CHAMPION program

## TL;DR

This study finds that cangrelor reduces ischemic events in patients with peripheral artery disease undergoing heart procedures without increasing severe bleeding risks.

## Contribution

The study provides new evidence that cangrelor is effective in reducing ischemic events in PAD patients undergoing PCI.

## Key findings

- PAD patients had higher odds of ischemic events and severe bleeding compared to non-PAD patients.
- Cangrelor reduced the primary endpoint in PAD patients compared to clopidogrel.
- Cangrelor did not increase GUSTO severe bleeding in either PAD or non-PAD patients.

## Abstract

Peripheral artery disease (PAD) is associated with an increased risk of ischemic events following percutaneous coronary intervention (PCI). More aggressive antiplatelet therapy may mitigate this risk. The present study evaluates the efficacy of cangrelor in patients with PAD undergoing PCI.

This is a pooled analysis from the CHAMPION PCI, CHAMPION PLATFORM, AND CHAMPION PHOENIX trials, evaluating cangrelor versus either clopidogrel or placebo in PCI patients. The occurrence of the primary endpoint of death, myocardial infarction, or ischemia-driven revascularization (IDR) was assessed in patients with and without PAD. GUSTO severe bleeding at 48 h was also evaluated. There were 1720 (7%) patients with PAD and 22,802 (93%) without PAD. After adjustment for differences in baseline variables, PAD patients, compared with those without PAD, experienced increased odds of the primary endpoint (OR [95% CI] = 1.27 [0.91, 1.77], P = 0.16) and GUSTO severe bleeding (OR [95% CI] = 3.24 [1.28, 8.21], P = 0.01). In PAD patients, the primary endpoint was 4.7% with cangrelor vs. 7.2% with clopidogrel (OR [95% CI] = 0.64 [0.42,0.96]); in patients without PAD the primary endpoint was 3.5% with cangrelor vs. 4.2% with clopidogrel (OR [95% CI] = 0.83 [0.72,0.95]), P-interaction 0.23. Among patients with or without PAD, there was no significant difference in the rate of GUSTO severe bleeding with cangrelor compared with control, P-interaction 0.86.

In a pooled analysis of the CHAMPION studies, PAD was associated with increased rates of ischemic and bleeding complications. Cangrelor reduced the odds of ischemic events, without increasing GUSTO severe bleeding.

clinicaltrials.gov identifiers: CHAMPION PCI (NCT00305162), CHAMPION PLATFORM

(NCT00385138), CHAMPION PHOENIX (NCT01156571)