Comparison of the effect of Morphine and Fentanyl in patients with acute coronary syndrome receiving Ticagrelor - The COMET (Comparison Morphine, Fentayl and Ticagrelor) randomized controlled trial
| Autor: | Shanmugasundram Sadhanandham, Balakrishnan Vinod Kumar, Phalgun Badimela, Sankaran Ramesh, Mano Vikash Vallivedu, Meena Iyer, Rathinasamy Jebaraj, Jayanthy Sathyanarayana Murthy, Febe Renjitha Suman, Sadagopan Thanikachalam, Jayanthy Venkata Balasubramaniyan, Usman Baber, Ganesan Karthikeyan, Nagendra Boopathy Senguttuvan, Thoddi Ramamurthy Muralidharan, Parasuram Krishnamoorthy, TamilAnbu Paneerselvam, Mahalakshmi Ramadoss, Preetam Krishnamurthy, Balakrishna Malepati, Panchanatham Manokar |
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| Rok vydání: | 2020 |
| Předmět: |
Acute coronary syndrome
Ticagrelor Platelet aggregation Platelet Aggregation 030204 cardiovascular system & hematology Fentanyl law.invention 03 medical and health sciences 0302 clinical medicine Percutaneous Coronary Intervention Randomized controlled trial law medicine Humans In patient 030212 general & internal medicine Acute Coronary Syndrome Adverse effect Morphine business.industry medicine.disease Treatment Outcome Anesthesia Cardiology and Cardiovascular Medicine business Platelet Aggregation Inhibitors medicine.drug |
| Zdroj: | International journal of cardiology. 330 |
| ISSN: | 1874-1754 |
| Popis: | Introduction Dual antiplatelet therapy (DAPT) remains the cornerstone of acute coronary syndrome (ACS) management, and ticagrelor is one of the commonly used second antiplatelet agents. There is some evidence to suggest that morphine may reduce the antiplatelet effect of ticagrelor. Methods and results In a single-center, randomized controlled trial, we compared the effect of morphine and fentanyl on platelet aggregation (PA) among patients with ACS treated with ticagrelor. Platelet aggregation was studied by automated light transmittance aggregometry (LTA) at baseline, and at 2 h after ticagrelor loading. The primary outcome was the difference in the maximal inhibition of platelet aggregation [IPA(%)] between the groups at 2 h. Pain relief, and drug-related adverse events were secondary outcomes. Of 136 patients randomized, 70 received fentanyl and 66 received morphine. At baseline, the median (IQR) platelet aggregation [61.35% (54.6 to 70) Vs. 58.8% (52.7 to 72.9)] were comparable between the groups. There was no statistically significant difference between the fentanyl and the morphine groups in IPA at 2-h [85.88%(64.65–98.16) and 81.93%(44.2–98.03), p = 0.09]. However, morphine use was independently associated with a PA of >30% at 2 h (p Conclusion In patients with ACS, there was no significant difference between the use of fentanyl or morphine on the effect of ticagrelor on PA. (CTRI/2018/04/013423). |
| Databáze: | OpenAIRE |
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