Evidence map›Paper›PMID 40813532›Full record

ArticleJournal of thrombosis and thrombolysis2026

Timing, indications and transition patterns associated with cangrelor use in patients undergoing PCI.

Angelo Oliva, Davide Cao, Mark Shneyderman, Gregory Serrao, Mauro Gitto, Francesca Maria Di Muro, Samantha Sartori, Yihan Feng, Birgit Vogel, Johny Nicolas and 11 more

Abstract read
PubMed Publisher
In one paragraph

Article in Journal of thrombosis and thrombolysis, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

21 authors.

Angelo OlivaThe Zena and Michael A. Wiener Cardiovascular Institute, Mount Sinai Fuster Heart Hospital, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1030, New York, NY, 10029, USA.ORCID http://orcid.org/0000-0003-0561-7563
Davide CaoThe Zena and Michael A. Wiener Cardiovascular Institute, Mount Sinai Fuster Heart Hospital, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1030, New York, NY, 10029, USA.
Mark ShneydermanThe Zena and Michael A. Wiener Cardiovascular Institute, Mount Sinai Fuster Heart Hospital, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1030, New York, NY, 10029, USA.
Gregory SerraoThe Zena and Michael A. Wiener Cardiovascular Institute, Mount Sinai Fuster Heart Hospital, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1030, New York, NY, 10029, USA.
Mauro GittoThe Zena and Michael A. Wiener Cardiovascular Institute, Mount Sinai Fuster Heart Hospital, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1030, New York, NY, 10029, USA.
Francesca Maria Di MuroThe Zena and Michael A. Wiener Cardiovascular Institute, Mount Sinai Fuster Heart Hospital, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1030, New York, NY, 10029, USA.
Samantha SartoriThe Zena and Michael A. Wiener Cardiovascular Institute, Mount Sinai Fuster Heart Hospital, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1030, New York, NY, 10029, USA.
Yihan FengThe Zena and Michael A. Wiener Cardiovascular Institute, Mount Sinai Fuster Heart Hospital, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1030, New York, NY, 10029, USA.
Birgit VogelThe Zena and Michael A. Wiener Cardiovascular Institute, Mount Sinai Fuster Heart Hospital, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1030, New York, NY, 10029, USA.
Johny NicolasThe Zena and Michael A. Wiener Cardiovascular Institute, Mount Sinai Fuster Heart Hospital, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1030, New York, NY, 10029, USA.
Joseph SweenyThe Zena and Michael A. Wiener Cardiovascular Institute, Mount Sinai Fuster Heart Hospital, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1030, New York, NY, 10029, USA.
Prakash KrishnanThe Zena and Michael A. Wiener Cardiovascular Institute, Mount Sinai Fuster Heart Hospital, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1030, New York, NY, 10029, USA.
Benjamin BayThe Zena and Michael A. Wiener Cardiovascular Institute, Mount Sinai Fuster Heart Hospital, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1030, New York, NY, 10029, USA.
James JohnsonThe Zena and Michael A. Wiener Cardiovascular Institute, Mount Sinai Fuster Heart Hospital, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1030, New York, NY, 10029, USA.
Parasuram MelarcodeThe Zena and Michael A. Wiener Cardiovascular Institute, Mount Sinai Fuster Heart Hospital, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1030, New York, NY, 10029, USA.
Giulio StefaniniDepartment of Biomedical Sciences, Pieve Emanuele (MI), Humanitas University, Milan, Italy.
Pedro MorenoThe Zena and Michael A. Wiener Cardiovascular Institute, Mount Sinai Fuster Heart Hospital, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1030, New York, NY, 10029, USA.
Annapoorna KiniThe Zena and Michael A. Wiener Cardiovascular Institute, Mount Sinai Fuster Heart Hospital, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1030, New York, NY, 10029, USA.
George DangasThe Zena and Michael A. Wiener Cardiovascular Institute, Mount Sinai Fuster Heart Hospital, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1030, New York, NY, 10029, USA.
Samin SharmaThe Zena and Michael A. Wiener Cardiovascular Institute, Mount Sinai Fuster Heart Hospital, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1030, New York, NY, 10029, USA.
Roxana MehranThe Zena and Michael A. Wiener Cardiovascular Institute, Mount Sinai Fuster Heart Hospital, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1030, New York, NY, 10029, USA. roxana.mehran@mountsinai.org.

Funding

Deutsche Herzstiftung S/06/23
6 · The paper itself

Abstract

Optimal antiplatelet therapy is crucial in percutaneous coronary intervention (PCI) to balance thrombotic and bleeding risk. Cangrelor, a rapid-acting intravenous P2Y12 inhibitor, is particularly effective in high-risk PCI scenarios, including acute coronary syndrome (ACS) or patients unable to take oral medications. The SMILE study evaluated real-world timing, indications, and outcomes of cangrelor use, along with transition to oral P2Y12 inhibitors, in high-risk patients undergoing PCI. A retrospective analysis of Mount Sinai PCI registry was conducted, examining consecutive patients receiving cangrelor from January 2018 to March 2024. Transition to oral P2Y12 inhibitors (ticagrelor, clopidogrel, or prasugrel) followed institutional protocols based on guidelines and expert consensus. The primary endpoint was in-hospital major adverse cardiac and cerebrovascular events (MACCE), including myocardial infarction, stroke, and all-cause death. Among 493 patients, 78.7% presented with ACS (29.6% STEMI; 14.8% cardiogenic shock) and 79.3% underwent complex PCI. Of these, 80.5% were subsequently transitioned to ticagrelor (N=397) and 19.5% to a thienopyridine (clopidogrel N=85, prasugrel N=11). MACCE incidence was 12.6%, while bleeding occurred in 4.3%. A lower risk of MACCE was associated with transition to ticagrelor (9.8% vs. 24.0%; adjusted OR 0.35, 95%CI 0.20-0.62, p < 0.001) and adherence to protocol for transition to oral P2Y12 inhibitors (10.9% vs. 19.4%; adjusted OR 0.51, 95%CI 0.28-0.94). Extended low-dose cangrelor infusion was well-tolerated in critically ill patients requiring prolonged parenteral antiplatelet therapy. Overall, the SMILE study demonstrated that adherence to standardized transition protocols enhances clinical outcomes in high-risk PCI patients receiving cangrelor, particularly when transitioned to ticagrelor. Further research is needed to validate these results across diverse populations and clinical settings.

Indexed as

Acute Coronary SyndromeAdenosine MonophosphatePercutaneous Coronary InterventionPlatelet Aggregation InhibitorsPurinergic P2Y Receptor AntagonistsAgedClopidogrelFemaleHemorrhageHumansMaleMiddle AgedPrasugrel HydrochlorideRegistriesRetrospective StudiesTicagrelorAdenosine MonophosphatecangrelorClopidogrelPlatelet Aggregation InhibitorsPrasugrel HydrochloridePurinergic P2Y Receptor AntagonistsTicagrelorAcute coronary syndromeCangrelorComplex PCIP2Y12 inhibitorsPercutaneous coronary intervention

Identifiers

PMID40813532

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.