In order to bring you the best possible user experience, this site uses Javascript. If you are seeing this message, it is likely that the Javascript option in your browser is disabled. For optimal viewing of this site, please ensure that Javascript is enabled for your browser.

The free consultation period for this content is over.

It is now only available year-round to ACVC Ivory (& above) Members, Fellows of the ESC and Young combined Members

Administration of intravenous fentanyl and laboratory efficacy of new p2y12 receptor antagonists in patients with STE myocardial infarction

Session Poster Session 1

Speaker Zuzana Motovska

Event : Acute Cardiovascular Care 2015

  • Topic : coronary artery disease, acute coronary syndromes, acute cardiac care
  • Sub-topic : Acute Coronary Syndromes: Antiplatelet Agents
  • Session type : Poster Session

Authors : Z Motovska (Prague,CZ), J Knot (Prague,CZ), M Ondrakova (Prague,CZ), F Bednar (Prague,CZ), J Ulman (Prague,CZ), M Maly (Prague,CZ), P Widimsky (Prague,CZ)

Authors:
Z Motovska1 , J Knot1 , M Ondrakova1 , F Bednar1 , J Ulman2 , M Maly3 , P Widimsky1 , 1Charles University Prague, 3rd Faculty of Medicine, Faculty Hospital Kralovske Vinohrady - Prague - Czech Republic , 2Faculty Hospital Kralovske Vinohrady - Prague - Czech Republic , 3National Institute of Public Health - Prague - Czech Republic ,

Citation:
European Heart Journal: Acute Cardiovascular Care ( 2015 ) 4 ( Supplement 5 ), S21

Aim. Presented study aimed to determine the influence of intravenous fentanyl, a synthetic opiate analgesic, on laboratory efficacy of new P2Y12 antagonists in patients with STE myocardial infarction treated with primary PCI.
Methods . Study population consisted of 143 patients with obtainable information about (non) administration of fentanyl who were participating in the LAPCOR registry (ClinicalTrials.gov NCT02264912).
P2Y12 antagonist efficacy was measured by VASP phosphorylation 24±4 hours after a loading dose of prasugrel (60 mg, N=80), or ticagrelor (180 mg, N=63) and expressed by platelet reactivity index (PRI). HTPR was defined as PRI ≥ 50%.
Results: Residual platelet reactivity in patients initiated on ticagrelor was (median, min to max) 14.3 (0.1 to 44.9)% in patients (N=29) receiving fentanyl, and 14.9 (0.3 to 46.2) % in patients (N=34) who did not (p=0.7). No HPTR was detected in ticagrelor-treated patients, irrespective of fentanyl administration. Residual platelet reactivity in patients initiated on prasugrel was (median, min to max) 13.3 (0.0 to 84.6)% in patients (N=30) receiving fentanyl, and 10.0 (0.3 to 56.4)% in patients (N=50) without fentanyl administration (p=0.13). Logistic regression showed that fentanyl administration did not significantly influence the probability of HTPR in prasugrel-treated patients (Odds Ratio (95% C.I.) 3.7 (0.6, 21.5), p=0.13). Controlling for baseline characteristics did not influence presented results.
Conclusion . Administration of fentanyl did not significantly diminish the maximal inhibition of platelet aggregation after a loading dose of new P2Y12 antagonists.

Characteristic Fentanyl No N= 84 Fentanyl Yes N = 59 P value
Age (Mean SD) Years 61.7 (11.8) 57.5 (11.8) 0.04
Female gender 20.2% 28.8% 0.3
Hypertension 67.9% 66.1% 0.9
Diabetes mellitus 28.6% 20.3% 0.2
Current smoker 64.2% 66.1% 0.9
Hyperlipidemia 31.0% 20.3% 0.2
Chronic kidney disease 11.9% 6.8% 0.4
LVEF ≤30% 11.9% 8.6% 0.6

Get your access to resources

Join now
  • 1ESC Professional Members – access all ESC Congress resources 
  • 2ESC Association Members (Ivory, Silver, Gold) – access your Association’s resources
  • 3Under 40 or in training - with a Combined Membership, access all resources
Join now

Our sponsors

ESC 365 is supported by Bayer, Boehringer Ingelheim and Lilly Alliance, Bristol-Myers Squibb and Pfizer Alliance, Novartis Pharma AG and Vifor Pharma in the form of educational grants. The sponsors were not involved in the development of this platform and had no influence on its content.

logo esc

Our mission: To reduce the burden of cardiovascular disease

Who we are