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Publications

Journal Article Multicenter Study Observational Study Ppublish

PubMed: 42765781 DOI: 10.2459/JCM.0000000000001939

Cangrelor in elderly patients undergoing percutaneous coronary intervention: findings from the ICARUS Registry.

J Cardiovasc Med (Hagerstown) 27(9):726-734

Authors: Stefano Benenati, Felice Gragnano, Sebastiano Stratoti, Riccardo Scalamera, Vincenzo De Sio, Antonio Capolongo, Arturo Cesaro, Gianmarco Annibali, Salvatore Campagnuolo, Angelo Silverio, Michele Bellino, Matteo Schettino, Edoardo Bertero, Letizia Carelli, Giorgio Caretta, Marco Rezzaghi, Francesco Veneziano, Gennaro De Rosa, Mario Centore, Davide De Nardo, Rocco Vergallo, Leonardo De Luca, Gennaro Galasso, Alberto Menozzi, Giuseppe Musumeci, Plinio Cirillo, Paolo Calabrò, Italo Porto

Affiliations

  • Università degli Studi di Genova.
  • U.O. Cardiologia, Dipartimento Cardio-Toraco-Vascolare (DICATOV), Ospedale Policlinico San Martino IRCCS - IRCCS Cardiovascular Network, Genova.
  • Dipartimento di Scienze Mediche e Chirurgiche Avanzate, Università della Campania 'Luigi Vanvitelli'.
  • Divisione di Cardiologia, Dipartimento Cardio-Vascolare, AORN Sant'Anna e San Sebastiano, Caserta.
  • Divisione di Cardiologia, A.O. Ordine Mauriziano, Torino.
  • UOC Cardiologia, Ospedale Augusto Murri, AST Fermo, Marche.
  • Dipartimento di Medicina, Chirurgia e Odontoiatria, Università di Salerno, Baronissi (Salerno).
  • Dipartimento Cardiotoracovascolare, Ospedale Universitario San Giovanni di Dio e Ruggi d'Aragona, Salerno.
  • S.C. Cardiologia, Ospedali del Tigullio - Polo Lavagna, Lavagna.
  • Struttura Complessa di Cardiologia, Ospedale S. Andrea, La Spezia, ASL5, Azienda Tutela della Salute Liguria.
  • Azienda ULSS 6 Euganea, Monselice, Padova.
  • Dipartimento di Scienze Biomediche Avanzate, Università di Napoli 'Federico II'.
  • U.O.C. Cardiologia, UTIC, Emodinamica P.O. Maria SS, Addolorata, Eboli, ASL Salerno.
  • UOC Cardiologia ASST Pavia.
  • Divisione di Cardiologia, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.

Abstract

BACKGROUND/OBJECTIVES

We aimed to assess the clinical characteristics and in-hospital outcomes of elderly vs. nonelderly patients treated with cangrelor during percutaneous coronary intervention (PCI).

METHODS

Patients undergoing PCI with cangrelor between January 2019 and May 2023 in seven Italian institutions were retrospectively enrolled. Patients aged ≥75 years at the time of PCI were classified as elderly. The primary endpoint was net adverse clinical events (NACE), a composite of cardiovascular death, myocardial infarction, stroke, definite or probable stent thrombosis, and Bleeding Academic Research Consortium (BARC) types 2, 3, or 5 bleeding, evaluated at 48 h post-PCI. The impact of advanced age (≥75 years) on clinical outcomes was assessed using multivariable logistic regression (LR), inverse probability of treatment weighting (IPTW), and doubly robust (DR) models.

RESULTS

A total of 1071 patients were included, of whom 340 (32%) were elderly. At 48 h, elderly patients had higher odds of NACE [odds ratio (OR) 2.11, 95% confidence interval (CI) 1.12-3.97, P = 0.021 by multivariable LR; OR 1.98, 95% CI 1.45-2.27, P < 0.001 with IPTW; and OR 2.09, 95% CI 1.51-2.93, P < 0.001 by DR estimation]. These results were driven by an increased risk of both ischemic and bleeding events, the latter including access-site and nonaccess-site hemorrhages of both minor and major severity.

CONCLUSIONS

In this real-world study of patients undergoing PCI with cangrelor, elderly individuals accounted for one-third of the population. Elderly patients were at higher risk of NACE, driven by both ischemic and bleeding events.

MeSH

Registries, Hemorrhage, Percutaneous Coronary Intervention, Aged