We have read not only with interest but also with great disappointment the article written by Lhermusier et al related with the overview of the Food and Drug Administration (FDA) about cangrelor. Since the first notification of its existence, the interventionalists have been waiting for this promising drug with the hope of having found an agent that would offer the ideal characteristics of to avoid the need of preloading and also to allow reversibility based on a short half-life. Unfortunately, the FDA has declined to approve cangrelor for PCI mainly because of the design of the CHAMPION-PHOENIX, CHAMPION-PLATFORM, and CHAMPION-PCI trials where the comparative drug clopidogrel was not administered in the best known manner, that is, pretreatment with 600 mg. Reading the article, it can be deduced that in the opinion of the FDA when any antithrombotic drug is compared in a trial with clopidogrel, the most correct way of administration of the latter is after preloading with 600 mg. In our opinion, there may be some confusion related with this issue. Although after previous trials where clopidogrel was administered at the time of the angiography, the guidelines endorsed a class I recommendation to the new drug and there were not any objection by the FDA to approve the new antiplatelet agent, and in the case of cangrelor, it seems that the opinion is quite different. As some investigators now are questioning if pretreatment is necessary because it has been deduced of classic trials, we believe that there may be some confusion about which should be the best control arm in the trials when a new drug is being tested. May be we are running too fast and the first step to put sense in all this mess is to clarify if really the best treatment we have is pretreatment of 600 mg of clopidogrel or if we should move forward toward more aggressive protocols with more modern drugs without pretreatment. It would be important to answer this question not only to improve the care of the patients but also to reduce the risk of wasting resources in trials that later will not be capable of convincing the agencies or the physicians. As the concerns related with the approval of cardiovascular drugs is progressively higher, we believe that it should be also important to provide to the trial designers the rules of the game so that they can develop the trial with the most available information. Clopidogrel offers some advantages as an unrestricted spectrum of patients, low rate of bleeding events, and a long experience with the drug, but it undoubtedly would be interesting to find a drug which would overcome the need of preloading and its irreversibility, so those patients who are derived to surgery soon after the angiography or those who finally have not coronary disease would not receive unnecessary treatments. We believe that the recent rejection of cangrelor by the FDA after a fully complete CHAMPION program with 4 trials suggests that we need a study to answer these questions.