P297 INTRAVENOUS CANGRELOR INFUSION IN HIGH BLEEDING RISK PATIENTS UNDERGOING PERCUTANEOUS CORONARY INTERVENTION: PRELIMINARY RESULTS OF THE ICARUS REGISTRY

Abstract

Abstract Aims To investigate the prevalence of high bleeding risk (HBR) criteria and compare clinical outcomes between HBR and non–HBR patients receiving cangrelor in the peri–percutaneous coronary intervention (PCI) phase. Methods Consecutive patients treated with cangrelor in 7 Italian institutions were retrospectively enrolled in the ICARUS (“Intravenous CAngrelor in high–bleeding Risk patients Undergoing percutaneouS coronary intervention”, NCT05505591) registry. HBR status was assessed according to the Academic Research Consortium (ARC–HBR) definition. The primary endpoint was net adverse clinical events (NACE), defined as a composite of cardiovascular death, myocardial infarction, stroke, definite or probable stent thrombosis and Bleeding Academic Research Consortium (BARC) 2, 3 or 5 bleeding, at 48 hours. Secondary endpoints were assessed at 48 hours and throughout the hospital stay. Results We enrolled 551 patients undergoing PCI with cangrelor between January 2019 and August 2022. HBR definition was met in 33% of cases. HBR patients were older (76±10 vs. 63±10 years, p<0.001), more frequently affected by peripheral arterial disease (16% vs. 8%, p=0.010), atrial fibrillation (24% vs. 2%, p<0.001), chronic kidney disease (35% vs. 3%, p<0.001), active cancer (7% vs. 0%, p<0.001) and heart failure (17% vs. 7%, p<0.001). At 48 hours, HBR patients had a significantly higher rate of NACE (13% vs. 6%, p=0.004), and BARC 2, 3 or 5 bleeding (12% vs. 4%, p=0.001). In the HBR group, the frequency of the primary endpoint increased proportionally to the HBR score. There was no significant difference with respect to other 48–hour and in–hospital endpoints. Conclusions Among consecutive patients treated with cangrelor in the peri–PCI phase, about 30% fulfilled the ARC–HBR definition. In the HBR subpopulation, the incidence of 48–hour adverse events was higher than in the non–HBR subgroup, primarily driven by a higher rate of clinically relevant and major bleeding.