دورية أكاديمية
Differential impact of fentanyl and morphine doses on ticagrelor-induced platelet inhibition in ST-segment elevation myocardial infarction: a subgroup analysis from the PERSEUS randomized trial.
| العنوان: | Differential impact of fentanyl and morphine doses on ticagrelor-induced platelet inhibition in ST-segment elevation myocardial infarction: a subgroup analysis from the PERSEUS randomized trial. |
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| المؤلفون: | Garin D; Department of Cardiology, Geneva University Hospitals, Geneva, Switzerland., Degrauwe S; Department of Cardiology, Geneva University Hospitals, Geneva, Switzerland., Carbone F; Department of Internal Medicine, First Clinic of Internal Medicine, University of Genoa, Genoa, Italy.; IRCCS Ospedale Policlinico San Martino Genoa, Italian Cardiovascular Network, Genoa, Italy., Musayeb Y; Department of Cardiology, Geneva University Hospitals, Geneva, Switzerland., Lauriers N; Department of Cardiology, Lausanne University Hospital, Lausanne, Switzerland., Valgimigli M; Istituto Cardiocentro Ticino, Ente Ospedaliero Cantonale, Lugano, Switzerland., Iglesias JF; Department of Cardiology, Geneva University Hospitals, Geneva, Switzerland. |
| المصدر: | Frontiers in cardiovascular medicine [Front Cardiovasc Med] 2024 Apr 02; Vol. 11, pp. 1324641. Date of Electronic Publication: 2024 Apr 02 (Print Publication: 2024). |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Frontiers Media S.A Country of Publication: Switzerland NLM ID: 101653388 Publication Model: eCollection Cited Medium: Print ISSN: 2297-055X (Print) Linking ISSN: 2297055X NLM ISO Abbreviation: Front Cardiovasc Med Subsets: PubMed not MEDLINE |
| أسماء مطبوعة: | Original Publication: Lausanne : Frontiers Media S.A., [2014]- |
| مستخلص: | Introduction: Among patients with ST-segment elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (PCI), intravenous fentanyl does not enhance ticagrelor-induced platelet inhibition within 2 h compared to morphine. The impact of the total dose of fentanyl and morphine received on ticagrelor pharmacodynamic and pharmacokinetic responses in patients with STEMI remains however undetermined. Materials and Methods: We performed a post-hoc subanalysis of the prospective, open-label, single-center, randomized PERSEUS trial (NCT02531165) that compared treatment with intravenous fentanyl vs. morphine among symptomatic patients with STEMI treated with primary PCI after ticagrelor pretreatment. Patients from the same population as PERSEUS were further stratified according to the total dose of intravenous opioids received. The primary outcome was platelet reactivity using P2Y Results: 38 patients with STEMI were included between December 18, 2015, and June 22, 2017. Baseline clinical and procedural characteristics were similar between low- and high-dose opioid subgroups. At 2 h, there was a significant correlation between PRU and both raw [regression coefficient (B), 0.51; 95% confidence interval (CI), 0.02-0.99; p = 0.043] and weight-weighted (B, 0.54; 95% CI, 0.49-0.59; p < 0.001) doses of fentanyl, but not morphine. Median PRU at 2 h was significantly lower in patients receiving low, as compared to high, doses of fentanyl [147; interquartile range (IQR), 63-202; vs. 255; IQR, 183-274; p = 0.028], whereas no significant difference was found in those receiving morphine (217; IQR, 165-266; vs. 237; IQR, 165-269; p = 0.09). At 2 h, weight-weighted doses of fentanyl and morphine were significantly correlated to plasma levels of ticagrelor and AR-C124910XX. Conclusion: In symptomatic patients with STEMI who underwent primary PCI after ticagrelor pretreatment and who received intravenous opioids, we found a dose-dependent relationship between the administration of intravenous fentanyl, but not morphine, and ticagrelor-induced platelet inhibition. Competing Interests: JFI has disclosed receiving research funding for his institution (Lausanne University Hospital, Switzerland) and personal compensation from AstraZeneca during the study; institutional research grants and personal fees from Abbott Vascular, Biotronik, Biosensors, Concept Medical, Philips Volcano, Terumo Corporation, in addition to personal fees from AstraZeneca, Biotronik, Biosensors, Concept Medical, Terumo Corporation, Medtronic, Medalliance, Novartis, Pfizer, Bristol Myers Squibb, and Cordis, related to activities outside the submitted manuscript; MV has acknowledged receiving both grants and personal fees from Abbott, Terumo Corporation, and AstraZeneca, personal fees from Bayer, Daiichi Sankyo, Amgen, Alvimedica, Idorsia, Coreflow, Vifor, BristolMyers Squibb, and iVascular, and funding from Medicare, all concerning endeavors outside the submitted work; SD has reported obtaining grants and personal fees from Biotronik, also unrelated to the submitted work. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (© 2024 Garin, Degrauwe, Carbone, Musayeb, Lauriers, Valgimigli and Iglesias.) |
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| فهرسة مساهمة: | Keywords: ST-segment elevation myocardial infarction; dose; fentanyl; pharmacodynamics; pharmacokinetics; ticagrelor |
| تواريخ الأحداث: | Date Created: 20240417 Latest Revision: 20240425 |
| رمز التحديث: | 20240425 |
| مُعرف محوري في PubMed: | PMC11018886 |
| DOI: | 10.3389/fcvm.2024.1324641 |
| PMID: | 38628315 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 2297-055X |
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| DOI: | 10.3389/fcvm.2024.1324641 |