In a real-world registry of patients undergoing PCI with cangrelor, elderly patients (≥75 years) accounted for one-third of the population and had approximately twice the odds of net adverse clinical events at 48 hours compared to nonelderly patients, driven by both ischemic and bleeding events.
Elderly patients (≥75 years) comprised approximately one-third of the total PCI population treated with cangrelor in this real-world registry.
Elderly patients had significantly higher odds of net adverse clinical events (NACE) at 48 hours post-PCI compared to nonelderly patients.
The increased risk of NACE in elderly patients was driven by both ischemic and bleeding events.
The study used three complementary statistical approaches to assess the impact of advanced age on clinical outcomes, all yielding consistent results.
This research examined how elderly patients (aged 75 and older) fare compared to younger patients when treated with cangrelor, a fast-acting blood-thinning drug given through an IV during heart procedures (percutaneous coronary intervention, or PCI). The study analyzed data from over 1,000 patients treated at seven Italian hospitals between 2019 and 2023. About one in three patients in this real-world dataset was elderly, reflecting how common this age group is among people undergoing these procedures. The study found that elderly patients were about twice as likely as younger patients to experience a combined outcome called 'net adverse clinical events' within 48 hours of their procedure. This outcome captured serious problems including heart attack, stroke, cardiovascular death, stent-related blood clots, and significant bleeding. Importantly, the increased risk in elderly patients was not due to just one type of problem — both dangerous blood clots (ischemic events) and bleeding complications were more common in older patients, and bleeding occurred at both the site where the catheter was inserted and at other locations throughout the body. This research suggests that elderly patients represent a substantial and high-risk segment of those receiving cangrelor during heart procedures in real-world clinical practice. The findings highlight that older patients face a particularly challenging balance between preventing dangerous clotting and avoiding serious bleeding. This dual risk in the elderly may have implications for how clinicians monitor and manage this age group during and after PCI, though further research would be needed to determine whether any specific adjustments to care could help improve outcomes.
Benenati S, Gragnano F, Stratoti S, Scalamera R, De Sio V, Capolongo A, et al.. (2026). Cangrelor in elderly patients undergoing percutaneous coronary intervention: findings from the ICARUS Registry.. Journal of cardiovascular medicine (Hagerstown, Md.). https://doi.org/10.2459/JCM.0000000000001939