An editorial accompanying this research notes that cangrelor was compared to placebo prior to PCI in most patients enrolled in the analysed CHAMPION studies – this is not consistent with current clinical practice (clopidogrel pre-treatment is standard in most centres). Another issue is the lack of comparative data for ticagrelor or prasugrel. The authors go on to discuss the situations in which cangrelor may have a particular role due to its IV administration and rapid onset, for example in the STEMI primary PCI setting (as there is little opportunity for pre-treatment; they call for a randomised trial of cangrelor versus placebo on top of optimum dual oral antiplatelet therapy to solidify its role in this setting).