Kengreal (cangrelor) / Chiesi - LARVOL DELTA

Automated Imaging and Analysis of Platelet, Coagulation and Fibrinolysis Activities Using a Novel Flow Chip-Based System at Physiological Temperature. (PubMed, Micromachines (Basel)) - "In platelet-sensitive mode, MC-2S demonstrated high sensitivity to antiplatelet therapy with aspirin or cangrelor. In coagulation-sensitive mode, it detected the anticoagulant effect of rivaroxaban plus its reversal by andexanet-α. In fibrinolysis-sensitive mode, it monitored tissue-type plasminogen activator-induced thrombus dissolution, inhibited by tranexamic acid. Collectively, the MC-2S platform was found to provide a versatile, physiologically relevant tool for functional hemostasis testing, with high potential for the acute and subacute evaluation of patient blood samples in the context of bleeding disorders, thrombosis risk, and drug monitoring."

Journal • Cardiovascular • Hematological Disorders • Thrombosis

The Impact of Cangrelor in the UK for the Treatment of STEMI Patients with Gastric Absorption Issues Undergoing Percutaneous Coronary Intervention. (PubMed, J Clin Med) - "Oral P2Y12 inhibitors (clopidogrel, prasugrel, and ticagrelor), glycoprotein IIb/IIIa inhibitors (eptifibatide and tirofiban), and aspirin and heparin alone were included as base case comparators. The introduction of cangrelor is estimated to lead to 314 fewer hospital days and 190 clinical events avoided over 5 years. Introducing cangrelor to STEMI patients with gastric absorption issues undergoing PCI in the UK is estimated to generate a small cost saving and reduced length of stay for some patients."

Journal • Cardiovascular • Myocardial Infarction

Use of Cangrelor for Patients Undergoing Coronary Artery Bypass Grafting: Insights From the CAMEO Registry. (PubMed, JACC Adv) - "Cangrelor use in patients with AMI undergoing CABG varies, with over 25% of cangrelor-treated patients receiving "bridge" dosing prior to CABG. Timing from hospital admission to CABG and overall length of stay were significantly shorter in cangrelor-treated patients."

Journal • Cardiovascular • Myocardial Infarction

Measuring Thrombin Generation in Platelet Rich Plasma with the ST Genesia (ASH 2023) - "The ST Genesia proved to be sensitive to platelet antagonists aspirin (100µM) and Cangrelor (500nM) as peak height decreased with 22% and 24%, respectively. The ST Genesia can be used for the reproducible measurement of TG in PRP up to two hours after loading the samples in the device."

BIRDGE 2: The Bridging Antiplatelet Therapy With Cangrelor 2 Study (clinicaltrials.gov) - P4 | N=50 | Not yet recruiting | Sponsor: University of Florida

New P4 trial • Cardiovascular • Coronary Artery Disease

Targeted Therapy, Collateral Damage: Navigating Acute Coronary Syndrome in the Era of Ponatinib (AHA 2025) - "Electrocardiogram showed 3 mm ST elevations in leads II, III, and aVF with reciprocal ST-depressions in the anterior leads, consistent with an acute inferior ST-elevation myocardial infarction.He was started on aspirin and heparin and taken emergently to the cardiac catheterization lab, where he received a loading dose of clopidogrel...He underwent aspiration thrombectomy and repeat percutaneous coronary intervention, and was started on intravenous cangrelor. The next morning, clopidogrel was switched to ticagrelor for enhanced antiplatelet effect...The cardiovascular sequalae of these agents pose clinical challenges. Investigation into the vascular toxicities of novel cancer therapies is urgently needed to guide future management."

Acute Coronary Syndrome • Acute Lymphocytic Leukemia • Anemia • Cardiovascular • CNS Disorders • Depression • Hematological Malignancies • Hypertension • Leukemia • Myocardial Infarction • Psychiatry • Thrombosis • ABL1 • BCR

Hippocampal GPR17 down regulation ameliorates CMS-induced depression-like behaviors in mice. (PubMed, Neuropharmacology) - "We down-regulated hippocampal GPR17 by injecting LV-GPR17-shRNA or the GPR17 antagonist cangrelor into the DG region of the mouse hippocampus...Moreover, we found that the antidepressant-like effects of GPR17 modulation were mediated through the hippocampal BDNF/CREB/TrkB pathway. Our findings suggest that GPR17 may be a promising therapeutic target for depression."

Journal • Preclinical • CNS Disorders • Depression • Inflammation • Mood Disorders • Psychiatry • BDNF

Comparative Effects of P2Y12 Inhibitors on Thrombus Biology and Inflammatory Responses in Atherothrombotic Cardiovascular Disease: A Systematic Review of Randomized Controlled Trials. (PubMed, Cureus) - "These trials examined ticagrelor, prasugrel, cangrelor, and genotype-guided strategies in comparison to clopidogrel, assessing outcomes such as inflammatory cell infiltration, platelet reactivity, and myocardial reperfusion parameters. Collectively, the available evidence provides preliminary mechanistic support for the hypothesis that certain P2Y12 inhibitors may exert anti-inflammatory and thrombus-modifying effects beyond their platelet-inhibiting effects. Larger, standardized, and mechanistically focused trials are warranted to validate these findings and guide precision-based antiplatelet therapy in cardiovascular disease."

Journal • Review • Acute Coronary Syndrome • Cardiovascular • Inflammation • Thrombosis • MPO

Iatrogenic aortocoronary dissection treated with bail-out stenting and requiring triple therapy: A case report (AHA 2025) - "Follow up CT chest showed a stable dissection flap, IV cangrelor was switched to aspirin and clopidogrel, and home apixaban was resumed. Hospital course was uneventful except for an episode of atrial fibrillation with rapid ventricular response, treated accordingly with beta blocker and amiodarone...She also was treated aggressively with high dose beta-blocker, as tolerated, to keep her heart rate below 60. Along with holding aspirin, these strategies resulted in hematoma resolution."

Case report • Clinical • Atrial Fibrillation • Cardiovascular

Results of Pilot Trials in the United States and Phase I Bridging Trials in China of a Novel Antiplatelet P2Y12 Inhibitor Evategrel (CG-0255) (AHA 2025) - "Clopidogrel treatment continued until day 7, cangrelor was used for comparison...Clopidogrel and prasugrel were used for comparison...Orally evategrel's IPA at very low doses matches or greatly surpasses that of clopidogrel. Evategrel fills unmet medical needs and will truly benefit patients."

P1 data • Amyloidosis • Cardiovascular • Metabolic Disorders

Comparative Efficacy of Cangrelor in Patients Undergoing PCI in the setting of Cardiogenic Shock or Cardiac Arrest: Insights from Blue Cross and Blue Shield of Michigan Cardiovascular Consortium (BMC2) Registry (AHA 2025) - "Cangrelor administration during PCI for AMI complicated by cardiogenic shock or cardiac arrest was not associated with a difference in in-hospital mortality but was associated with increased major bleeding and transfusions."

Clinical • Cardiovascular • Myocardial Infarction

Cangrelor Versus Oral P2Y12 Inhibitors During PCI in Cardiogenic Shock and Cardiac Arrest: A Systematic Review and Meta-analysis (AHA 2025) - "Cangrelor use during PCI in cardiogenic shock was associated with lower mortality and no excess bleeding, supporting its use in this high-risk group. However, in out-of-hospital cardiac arrest, the increased risk of bleeding warrants caution. These findings suggest a phenotype-specific approach to antiplatelet therapy in patients undergoing PCI under critical conditions."

Retrospective data • Review • Cardiovascular • Hematological Disorders • Thrombosis

DIRECT MECHANICAL THROMBECTOMY FOR ACUTE ISCHAEMIC STROKE IN A PATIENT WITH LARGE FRONTAL MENINGIOMA AND PULMONARY EMBOLISM (WSC 2025) - "A microcatheter was advanced through occluded ICA into M1 segment.Stent-retriever was deployed across thrombus and retrieved under simultaneous aspiration.Two passes achieved successful reperfusion of left MCA and ACA (TICI 2b/3),despite persistent occlusion at ICA origin.Patient stabilized neurologically post-intervention.Post-reperfusion, systemic anticoagulation was initiated with intravenous heparin and cangrelor to manage pulmonary emboli. This case exemplifies complex decision-making and the importance of multi-disciplinary coordination at the intersection of neurointerventional and systemic thromboembolic management. This case exemplifies complex decision-making and the importance of multi-disciplinary coordination at the intersection of neurointerventional and systemic thromboembolic management. Key Takeaways : ➢ Thrombectomy as first-line therapy: In patients with absolute contraindications to thrombolytics, mechanical thrombectomy can achieve rapid reperfusion..."

Clinical • Brain Cancer • Cardiovascular • Cerebral Hemorrhage • CNS Disorders • Hematological Disorders • Hypertension • Ischemic stroke • Meningioma • Pulmonary Disease • Pulmonary Embolism • Respiratory Diseases • Solid Tumor

OPTIMAL INTRAPROCEDURAL ANTIPLATELET STRATEGY DURING RESCUE STENTING FOR REFRACTORY LARGE VESSEL OCCLUSION: A SUB-STUDY OF THE RESISTANT REGISTRY (WSC 2025) - "Antiplatelet regimens were classified as intravenous (IV-APT) (cangrelor, tirofiban, eptifibatide, abciximab), single oral (aspirin, clopidogrel, ticagrelor), or dual oral therapy. ConclusionsIntraprocedural intravenous antiplatelet therapy was associated with improved procedural success and reduced re-occlusion without a significant impact on hemorrhagic or functional outcomes. These findings support the procedural safety of IV antiplatelets and highlight their potential benefit in optimizing reperfusion outcomes during rescue stenting."

Cerebral Hemorrhage • CNS Disorders • Hematological Disorders

CESSATION OF CANGRELOR: A CASE OF IN STENT THROMBOSIS (CHEST 2025) - "Though there are current literature-based guidelines for the cessation of antiplatelet bridging therapy, our case demonstrates the need to individually assess and implement a cessation timeframe based on a patient's history."

Clinical • Cardiovascular • Coronary Artery Disease • Diabetes • Hematological Disorders • Hypertension • Metabolic Disorders • Thrombosis • Ventricular Tachycardia

BRIDGING THE GAP: CANGRELOR TO CABG (CHEST 2025) - "Electrocardiogram identified an inferior STEMI, and the patient was loaded with aspirin and ticagrelor...Following his procedure, he was restarted on cangrelor infusion and then transitioned to aspirin and clopidogrel for 12 months on discharge... Given its short half-life, quick onset of action, and potent antiplatelet effect, cangrelor can serve as effective bridge therapy for patients undergoing surgical or interventional procedures. Further research on cangrelor bridge therapy should be conducted to outline potential benefits and risks."

Cardiovascular • Coronary Artery Disease • Hematological Disorders • Myocardial Infarction • Thrombosis

A CASE OF ACUTE CORONARY SYNDROME AND CARDIOGENIC SHOCK MANAGED WITH STENTING ACROSS LARGE SERIAL LAD CORONARY ARTERY ANEURYSMS (CHEST 2025) - "He was admitted to the Cardiac ICU on Cangrelor infusion and intra-aortic balloon pump... This case highlights the importance of multidisciplinary management of less common and more complex clinical scenarios without clear guideline recommendations, such as CAAs complicated by acute coronary syndrome and ambiguous angiographic anatomy. Ultimately, successful PCI with DES was performed with stent-exclusion of the CAAs, which demonstrated thrombosis and shrinkage behind the stent on serial outpatient imaging evaluations."

Clinical • Acute Coronary Syndrome • Cardiovascular • Coronary Artery Disease • Hematological Disorders • Myocardial Infarction • Thrombosis

A RARE CASE OF TICAGRELOR-INDUCED CHEYNE-STOKES RESPIRATIONS (CHEST 2025) - "After demonstrating a period of sustained hemostasis and hemodynamic stability, a cangrelor drip was initiated with the plan transition the patient to monotherapy with ticagrelor.Shortly after receiving a loading and maintenance dose of ticagrelor, patient developed severe respiratory distress...Antiplatelet therapy with clopidogrel was resumed without incidence... Ticagrelor is a first-line antiplatelet medication used in many patients who undergo coronary intervention. is essential that clinicians be aware of potential adverse effects and recognize when uncommon events occur. Ticagrelor-induced CSR is rare, though if left untreated, has the potential to result in arrythmia and sudden cardiac death."

Clinical • Cardiovascular • Congestive Heart Failure • Coronary Artery Disease • Heart Failure • Hematological Disorders • Ischemic stroke • Metabolic Disorders • Pulmonary Disease • SLC29A1

Unexplained Platelet Aggregation Requiring Argatroban and Cangrelor During Carotid Endarterectomy (ASA 2025) - "We present a case of repeated intraoperative carotid artery platelet aggregation in a patient with undiagnosed essential thrombocytosis after patch angioplasty despite anticoagulation with heparin, ultimately requiring initiation of argatroban and cangrelor. Our case demonstrates a unique pathogenesis of repeated acute platelet aggregation in the setting of an undiagnosed hematological disorder despite standard anticoagulation protocol, highlighting the importance of having an alternative, protocolized anticoagulation plan that incorporates direct thrombin inhibitors and antiplatelet agents."

Anesthesia • Cardiovascular • Essential Thrombocythemia • Hematological Disorders • Thrombocytosis

Management of an Epidural with Cangrelor drip post MI (ASA 2025) - "There are no guidelines for epidural removal while a patient is receiving cangrelor. Several multidisciplinary discussions involving surgical oncology, cardiology, and anesthesia were held to determine how and when to successfully remove the epidural while on an infusion of cangrelor."

Anesthesia • Cardiovascular

Life vs. Limb: anesthetic management of a neuraxial catheter in the setting of urgent IV antiplatelet administration (ASA 2025) - "The patient's GI tract viability depended on the graft's patency, necessitating urgent IV antiplatelet therapy (cangrelor) to be administered with a catheter in situ - risking epidural hematoma formation and paralysis. Postoperatively, an unknown splenic laceration was discovered in the setting of ongoing IV antiplatelet therapy, requiring emergent splenectomy. We will detail a multidisciplinary approach regarding management of neuraxial catheters in the setting of urgent IV antiplatelet administration."

Anesthesia • CNS Disorders • Gastrointestinal Disorder

Reply to "Bleeding events of cangrelor usage for the treatment of patients with acute coronary syndrome: Gender differences or study design Bias?". (PubMed, Int J Cardiol) - No abstract available

Journal • Acute Coronary Syndrome • Cardiovascular

Intraprocedural cangrelor during mechanical thrombectomy for acute ischemic stroke: a systematic review and single-arm meta-analysis. (PubMed, Neurol Res) - "Ninety-day mortality was 30.9% (95% CI: 0.179-0.480), with consistent estimates across leave-one-out analyses (range: 0.234-0.362). Cangrelor appears to be a safe and effective intraprocedural antiplatelet agent during mechanical thrombectomy for acute ischemic stroke."

Journal • Retrospective data • Review • Cardiovascular • Cerebral Hemorrhage • CNS Disorders • Gastroenterology • Hematological Disorders • Ischemic stroke • Thrombosis

A Patient Presenting with Joint Deformities and ST-Elevation Myocardial Infarction. (PubMed, Diagnostics (Basel)) - "Following a Heart Team consultation, the patient was bridged with cangrelor and underwent urgent hybrid coronary artery bypass grafting and left atrial appendage occlusion. Despite standard therapies, this patient experienced continued disease progression, prompting referral for advanced treatment with pegloticase and canakinumab. Multidisciplinary care and personalized strategies are essential in managing severe, refractory gout with multi-organ involvement."

Journal • Atrial Fibrillation • Cardiovascular • Chronic Kidney Disease • Congestive Heart Failure • Coronary Artery Disease • Gout • Heart Failure • Hypertension • Inflammatory Arthritis • Myocardial Infarction • Nephrology • Rheumatology

Comparative Efficacy and Safety of Intravenous Cangrelor versus Intravenous Glycoprotein IIb/IIIa Inhibitors after Mechanical Thrombectomy for Patients with Acute Ischemic Stroke: A Systematic Review and Meta-Analysis. (PubMed, AJNR Am J Neuroradiol) - "Cangrelor shows comparable efficacy to GP IIb/IIIa I in functional outcomes, with improved reperfusion, suggesting it as a viable alternative during MT procedures. Further randomized controlled trials are needed for comprehensive evaluation."

Clinical • Journal • Retrospective data • Review • Cardiovascular • Cerebral Hemorrhage • Hematological Disorders • Ischemic stroke