Süleyman Sezai YILDIZ, İlker GÜL, Fatih AYTEMİZ, Metehan KİBAR, Cuma SÜLEYMAOĞLU, Halil FEDAİ, Alp Burak ÇATAKOĞLU, Şükrü ÇETİN, Selin YÖNDEM, Mehmet Vefik YAZICIOĞLU, Diyar KÖPRÜLÜ, Mustafa ÇETİN, Beytullah ÇAKAL, Çağrı YAYLA, Selçuk KORKMAZ, Servet ALTAY
Interventional Cardiology Perspectives - 2026;2(2):49-58
Background: Cangrelor, an intravenous and reversible P2Y12 receptor antagonist, is approved for use in patients undergoing primary and non-primary percutaneous coronary intervention (PCI). Aim: To evaluate the efficacy and safety of glycoprotein IIb/IIIa (GP IIb/IIIa) inhibitors initiated during PCI in patients with acute coronary syndrome (ACS) or chronic coronary syndrome (CCS) receiving cangrelor therapy. Study Design: Retrospective, multicenter study. Methods: This subgroup analysis of previously reported real-world data on cangrelor use in Türkiye evaluated the effects of GP IIb/IIIa inhibitors on bleeding, ischemic events, and mortality during follow-up in patients receiving cangrelor. Results: A total of 411 patients were included (mean age: 63.8+/-12.7 years; 76% male). Of these, 44 patients (10.7%) received GP IIb/IIIa inhibitors in addition to cangrelor (mean age: 68.0+/-11.3 years; 79% male). Kaplan-Meier analysis showed no significant difference in 12-month overall survival between coronary artery disease groups (log-rank p=0.392). In Firth penalized logistic regression analysis adjusting for age, sex, cardiogenic shock, chronic kidney disease, and femoral vascular access, GP IIb/IIIa inhibitor use was identified as an independent and significant predictor of 48-hour bleeding (odds ratio: 8.44, 95% confidence interval: 3.54-20.18, p<0.001). Conclusion: This study represents the first large-scale, multicenter retrospective analysis in Türkiye to examine the concomitant use of GP IIb/IIIa inhibitors with cangrelor in a high-risk population of patients with ACS and CCS. The findings suggest that combining GP IIb/IIIa inhibitors with cangrelor does not improve clinical outcomes but significantly increases the incidence of mild-to-moderate bleeding events.
