A randomised, investigator-initiated, clinical trial of the effects of fentanyl on P2Y12-receptor inhibition in patients with ST-elevation myocardial infarction who are pre-treated with crushed ticagrelor

Autor: Saman Rasoul, A. W. J. van ’t Hof, Rudolf T Tolsma, E. Kedhi, R. S. Hermanides, J. P. Ottervanger, Robbert J. Slingerland, Anne H. Tavenier, S. van Workum
Přispěvatelé: MUMC+: MA Med Staf Spec Cardiologie (9), RS: Carim - H01 Clinical atrial fibrillation, Cardiologie, RS: CARIM - R2.01 - Clinical atrial fibrillation
Jazyk: angličtina
Rok vydání: 2019
Předmět:
Ticagrelor
Platelet inhibition
medicine.medical_treatment
PERCUTANEOUS CORONARY INTERVENTION
MORPHINE USE
030204 cardiovascular system & hematology
law.invention
03 medical and health sciences
0302 clinical medicine
P2Y12
Randomized controlled trial
law
Clinical endpoint
Medicine
cardiovascular diseases
030212 general & internal medicine
Myocardial infarction
CARDIOVASCULAR EVENTS
TREATMENT PLATELET REACTIVITY
INTRAVENOUS FENTANYL
business.industry
SEGMENT ELEVATION
Primary percutaneous coronary intervention
Percutaneous coronary intervention
ASSOCIATION
AGGREGATION
medicine.disease
Clinical trial
Fentanyl
surgical procedures
operative
ST-elevation myocardial infarction
Anesthesia
Conventional PCI
Cardiology and Cardiovascular Medicine
business
ACETAMINOPHEN
Original Article – Design Study Article
medicine.drug
TASK-FORCE
Zdroj: Netherlands Heart Journal
Netherlands Heart Journal, 27(4), 185-190. Bohn Stafleu van Loghum
ISSN: 1876-6250
1568-5888
Popis: Background Fast and accurate platelet inhibition is an important therapeutic goal in the acute treatment of patients with ST-elevation myocardial infarction (STEMI). Platelet inhibitory effects induced by oral P2Y12-receptor antagonists are delayed in STEMI patients undergoing primary percutaneous coronary intervention (PCI) due to haemodynamic changes and delayed gastro-intestinal absorption. Concomitant use of opioids, although recommended in the American College of Cardiology/American Heart Association and European Society of Cardiology STEMI guidelines, further delays gastro-intestinal absorption. To date, trials investigating alternative analgesics in STEMI patients have been scarce. This trial aims to assess the feasibility of a novel drug strategy for treatment of STEMI patients with crushed ticagrelor in combination with paracetamol (acetaminophen) instead of opioids. Hypothesis STEMI patients who are pre-treated with crushed ticagrelor and paracetamol have a higher level of platelet inhibition after primary PCI than patients pre-treated with crushed ticagrelor and fentanyl. Study design The Opioids aNd crushed Ticagrelor In Myocardial infarction Evaluation (ON-TIME 3) trial is a randomised controlled trial designed to examine whether administration of paracetamol instead of fentanyl can optimise platelet inhibition in STEMI patients who are pre-treated with crushed ticagrelor in the ambulance. One hundred and ninety patients with STEMI will be randomised (1:1 fashion) to intravenous (IV) fentanyl or IV paracetamol. The primary endpoint is the level of platelet reactivity units measured immediately after primary PCI. Summary The ON-TIME 3 trial (NCT03400267) aims to achieve optimal platelet inhibition and pain relief in STEMI patients receiving crushed ticagrelor in the ambulance by investigating IV fentanyl and IV paracetamol as analgesics.
Databáze: OpenAIRE
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