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Systematic review and meta-analysis

This trial is included in the following systematic reviews and meta-analyses:

percutaneous coronary intervention - antithrombotics - all type of patients

acute coronary syndrome - New P2Y12 Inhibitors - all type of patients


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See also:

  • All percutaneous coronary intervention clinical trials
  • All acute coronary syndrome clinical trials
  • All clinical trials of New P2Y12 Inhibitors
  • All clinical trials of cangrelor up front
  •  

    CHAMPION-PLATFORM study, 2009

    [NCT00385138] download pdf: cangrelor up front | antithrombotics for percutaneous coronary intervention

    Treatments

    Studied treatment cangrelor up front (cangrelor during PCI followed by 600 mg of clopidogrel)
    cangrelor (in a bolus of 30 ìg per kilogram of body weight and an infusion of 4 ìg per kilogram per minute) for the duration of the PCI procedure, with a minimum infusion duration of 2 hours and a maximum of 4 hours
    Control treatment delayed clopidogrel (placebo during PCI followed by 600 mg of clopidogrel)
    placebo bolus and infusion for the duration of the PCI procedure
    Remarks cangrelor up front vs delayed clopidogrel

    Patients

    Patients patients with acute coronary syndrome undergoing percutaneous coronary intervention
    Inclusion criteria age of at least 18 years, diagnostic coronary angiography revealing at least one atherosclerotic lesion amenable to PCI with or without stent implantation, and evidence of either myocardial infarction without ST-segment elevation or unstable angina
    Remarks Patients with stable angina were initially eligible at the beginning of the trial before a protocol amendment

    Method and design

    Randomized effectives 2693 / 2669 (studied vs. control)
    Design Parallel groups
    Blinding double blind
    Follow-up duration 48 h
    Number of centre 218
    Geographic area 18 countries
    Primary endpoint death, MI, ischemia-driven revascularization


    Results



    Endpoints and data reported in the trial's publication(s)

    Endpoint Events (%) Relative Risk 95% CI
    Studied treat. Control treat.
    Death, MI, ischemia-driven revascularization 187 / 2691 (6,9%) 213 / 2664 (8,0%) 0,87 [0,72;1,05]
    Myocardial infarction 177 / 2691 (6,6%) 192 / 2664 (7,2%) 0,91 [0,75;1,11]
    Ischemia-driven revascularization 19 / 2691 (0,7%) 26 / 2664 (1,0%) 0,72 [0,40;1,30]
    Death from any cause 8 / 2691 (0,3%) 19 / 2664 (0,7%) 0,42 [0,18;0,95]
    Stroke 7 / 2691 (0,3%) 6 / 2664 (0,2%) 1,15 [0,39;3,43]
    Stent thrombosis 5 / 2691 (0,2%) 16 / 2664 (0,6%) 0,31 [0,11;0,84]
    Q-wave myocardial infarction 4 / 2691 (0,1%) 9 / 2664 (0,3%) 0,44 [0,14;1,43]
    Death, Q-wave myocardial infarction, ischemia-driven revascularization 25 / 2691 (0,9%) 44 / 2664 (1,7%) 0,56 [0,35;0,92]
    Not calculable (data not available)
    Death, Q-wave myocardial infarction, or stent thrombosis 15 / 2691 (0,6%) 36 / 2664 (1,4%) 0,41 [0,23;0,75]

    Endpoints used by the meta-analysis and data retained for this trial

    Endpoint Studied treat.
    n/N
    Control treat.
    n/N
    Graph RR [95% CI]

    stroke (fatal and non fatal)

    7 / 2691
    6 / 2664
    classic 1,15 [0,39;3,43]

    MI (fatal and non fatal)

    177 / 2691
    192 / 2664
    0,91 [0,75;1,11]
    0 2 1.0

    Relative risks
    Endpoint Events (%) Relative Risk 95% CI Endpoint definition
    in the trial
    Ref
    Studied treat. Control treat.
    MI (fatal and non fatal) 177 / 2691 (6,6%) 192 / 2664 (7,2%) 0,91 [0,75;1,11] Myocardial infarction
    stroke (fatal and non fatal) 7 / 2691 (0,3%) 6 / 2664 (0,2%) 1,15 [0,39;3,43] Stroke
    The primary endpoint (if exists) appears in blod characters
    Reference(s) used for data extraction:

    Endpoint studied treat. control treat. mean diff

    Absolute risk reduction
    Endpoint Events rate Absolute risk
    reduction (ARR)
    Studied treat. Control treat.
    MI (fatal and non fatal) 6,58% 7,21% -6,3‰
    stroke (fatal and non fatal) 2,60‰ 2,25‰ 0,3‰

    Meta-analysis of all similar trials:

    antithrombotics in percutaneous coronary intervention for all type of patients

    New P2Y12 Inhibitors in acute coronary syndrome for all type of patients



    Reference(s)

    Trials register # NCT00385138
    • Bhatt DL, Lincoff AM, Gibson CM, Stone GW, McNulty S, Montalescot G, Kleiman NS, Goodman SG, White HD, Mahaffey KW, Pollack CV Jr, Manoukian SV, Widimsky P, Chew DP, Cura F, Manukov I, Tousek F, Jafar MZ, Arneja J, Skerjanec S, Harrington RA. Intravenous Platelet Blockade with Cangrelor during PCI.. N Engl J Med 2009 Nov 15;:
      Pubmed | Hubmed | Fulltext

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