Comparative effects of fentanyl versus morphine on platelet inhibition induced by ticagrelor in patients with ST-segment elevation myocardial infarction: Full results of the PERSEUS randomized trial
Why the study?
Does intravenous fentanyl improve platelet inhibition at 2 hours compared to intravenous morphine in STEMI patients undergoing primary PCI after ticagrelor loading dose?
Population
38 STEMI patients undergoing primary PCI requiring analgesia
Comparison
Intravenous fentanyl vs intravenous morphine after ticagrelor loading dose
Design
Prospective, single-center, open-label, randomized controlled study
Authors
Discussion
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Implication
Fentanyl was not superior for 2-hour platelet inhibition versus morphine; challenges assumptions on opioid selection in ticagrelor-treated STEMI and extends data on timing effects.
Structured PICO
Does intravenous fentanyl improve platelet inhibition at 2 hours compared to intravenous morphine in STEMI patients undergoing primary PCI after ticagrelor loading dose?
P
Population
38 patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI) who required analgesia
I
Intervention
Intravenous fentanyl after ticagrelor loading dose
C
Comparator
Intravenous morphine after ticagrelor loading dose
O
Outcome
Platelet reactivity at 2 hours after ticagrelor loading dose assessed by P2Y12 reaction units (PRU)surrogate
In STEMI patients undergoing primary PCI, fentanyl did not significantly improve platelet inhibition at 2 hours compared to morphine after ticagrelor loading, although it increased platelet inhibition at 4 hours.
Limitations
- Prematurely stopped after enrolment of 38 out of 56 planned patients
Cite This Study
Iglesias et al. (2022) studied this question.