Christiana Care participated in a landmark clinical study of an experimental drug shown to be significantly more effective at preventing blood clots during coronary stenting procedures compared to the anti-clotting agent now typically used.
Given intravenously, the new anti-clotting drug cangrelor reduced the odds of complications from stenting procedures — primarily blood clots, but also heart attacks and strokes — by 22 percent when compared with the routinely used anti-platelet drug clopidogrel (brand name Plavix), according to the CHAMPION PHOENIX study, published March 10 in the New England Journal of Medicine.
“This trial delivered very clear results,” said Michael Stillabower, M.D., director of Cardiovascular Trials at Christiana Care, who served as the site principal investigator for this study. “This new medication can reduce complications in patients receiving coronary stents for a wide variety of indications. In addition to being much quicker to take effect and more potent than currently available treatment options, this intravenous drug is reversible and has a fast offset of action, which could be an advantage if emergency surgery is needed.”
Coronary artery stents are used in the majority of patients who undergo percutaneous coronary intervention, a common medical procedure performed on an estimated 600,000 patients in the United States each year. Interventional cardiologists perform PCI in the catheterization laboratory to reopen arteries in the heart that have become narrowed or blocked because of coronary artery disease, which affects an estimated 14 million Americans. In order to prevent blood clotting during PCI, patients are routinely given oral doses of clopidogrel. The drawback with this drug is that it is only available orally, which can make it difficult to administer. The drug is also slow to take effect and remains active for days after the procedure.
“We need a very potent agent to prevent clotting when we are putting things in the heart artery, like wires and stents,” said Deepak L. Bhatt, M.D., MPH, lead author of the study and senior physician at Brigham and Women’s Hospital, chief of cardiology at the VA Boston Healthcare System and professor of medicine at Harvard Medical School. “We want a fast-acting, reversible agent, which is why a drug like cangrelor could be useful and why we tested it.”
The study, a randomized, double-blind phase 3 trial begun in 2010, compared the use of intravenously administered cangrelor to orally administered clopidogrel in about 11,000 PCI patients at 153 centers around the world, including at the Center for Heart & Vascular Health at Christiana Care.