Abstract 16827: Safety and Efficacy of Cangrelor in Acute Coronary Syndromes: A Systematic Review and Network Meta-Analysis

Abstract

Introduction and Hypothesis: Cangrelor is a potent intravenous non-thienopyridine P2Y12 inhibitor. We conducted a network meta-analysis to study the efficacy and safety of cangrelor compared to oral P2Y12 inhibition or placebo in acute coronary syndromes. Methods: This meta-analysis followed the Cochrane collaboration guidelines and the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) protocols. Outcomes of interest included all-cause mortality, myocardial infarction, stent thrombosis, major bleeding, minor bleeding, and the need for blood transfusion. Results: In a network meta-analysis of 6 studies comprising 26,444 patients, Both cangrelor and clopidogrel showed no statistically significant difference compared to placebo in all-cause mortality (P= 0.46, I 2 = 22%) [Figure 1], myocardial infarction (P= 0.50, I 2 = 24%) [Figure 2], stent thrombosis (P= 0.84, I 2 = 0%) [Figure 3], major bleeding (P= 0.73, I 2 = 11%) [Figure 4], or the need for blood transfusion (P= 0.43, I 2 = 17%) [Figure 6]. Additionally, clopidogrel did not show a significant difference in the occurrence of minor bleeding compared to placebo. However, cangrelor was linked to an increased risk of minor bleeding (P=0.04, I2=54%) [Figure 5]. Conclusion: Cangrelor has comparable outcomes to clopidogrel in patients with acute coronary syndromes and can be used as a reliable alternative in this population.