scholarly journals IMPACT OF MORPHINE ADMINISTRATION ON TICAGRELOR-INDUCED PLATELET INHIBITION IN ST-ELEVATION MYOCARDIAL INFARCTION PATIENTS TREATED BY PRIMARY PCI: RESULTS FROM THE PRIVATE-ATLANTIC STUDY

2015 ◽  
Vol 65 (10) ◽  
pp. A15 ◽  
Author(s):  
Johanne Silvain ◽  
Robert Storey ◽  
Guillaume Cayla ◽  
Jean-Baptiste Esteve ◽  
Jean-Guillaume Dillinger ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Platelet Inhibition ◽  
St Elevation Myocardial Infarction ◽  
Primary Pci ◽  
Morphine Administration ◽  
St Elevation

scholarly journals Sex Differences in Platelet Reactivity in Patients With ST-Elevation Myocardial Infarction: A Sub-Analysis of the ON-TIME 3 Trial

2021 ◽  
Vol 8 ◽  
Author(s):  
Anne H. Tavenier ◽  
Renicus S. Hermanides ◽  
Jan Paul Ottervanger ◽  
Svetlana V. Belitser ◽  
Olaf H. Klungel ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Sex Differences ◽  
Platelet Reactivity ◽  
Plasma Concentrations ◽  
Multivariable Analysis ◽  
Platelet Inhibition ◽  
St Elevation Myocardial Infarction ◽  
Primary Pci ◽  
St Elevation ◽  
Male Patients

Background: Fast and adequate platelet inhibition is one of the cornerstones in the treatment of patients with ST-elevation myocardial infarction (STEMI). The aim of this analysis is to examine sex differences in platelet inhibition in the acute treatment of STEMI patients.Methods: Platelet reactivity units (PRU) and ticagrelor plasma concentrations of all patients in the ON-TIME 3 were compared according to sex. All patients were pre-treated with crushed ticagrelor, aspirin and heparin. Both univariable and multivariable analyses were performed.Results: In this sub-analysis of the ON-TIME 3 trial, 195 STEMI patients, of which 58 female patients (29.7%) and 137 male patients (70.3%), were analyzed. PRU-values immediately post-PCI were not different in females [median 135 (IQR 47-228)] compared to males [160 (IQR 40-219), P = 0.92]. Ticagrelor plasma concentrations were higher in the females at the start of primary PCI [141 ng/mL (IQR 25-491) vs. 76 ng/mL (IQR 15-245), P = 0.049] and at 6 hours post-primary PCI [495 ng/mL (IQR 283-661) vs. 321 ng/mL (IQR 196-537), P = 0.001] compared to males. However, immediately post-primary PCI and at 1-hour post-primary PCI no significant differences in ticagrelor concentrations were seen between sexes. In multivariable analysis, sex was significantly associated with ticagrelor concentration (P = 0.04), but not with PRU (P = 0.93).Conclusion: Effective platelet inhibition reached by crushed ticagrelor in STEMI patients was similar in both sexes. Females had similar or even higher ticagrelor plasma concentrations up to 6 hours post-primary PCI compared with males.

scholarly journals Impact of opioids on P2Y12 receptor inhibition in patients with ST-elevation myocardial infarction who are pre-treated with crushed ticagrelor: Opioids aNd crushed Ticagrelor In Myocardial infarction Evaluation (ON-TIME 3) trial

2020 ◽  
Author(s):  
Anne H Tavenier ◽  
Renicus S Hermanides ◽  
Jan Paul Ottervanger ◽  
Rudolf Tolsma ◽  
Antony van Beurden ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Pain Relief ◽  
Platelet Reactivity ◽  
Coronary Intervention ◽  
Platelet Inhibition ◽  
St Elevation Myocardial Infarction ◽  
P2y12 Receptor ◽  
Primary Pci ◽  
Receptor Inhibition ◽  
St Elevation

Abstract Aims Platelet inhibition induced by P2Y12 receptor antagonists in patients with ST-elevation myocardial infarction (STEMI) can be affected by concomitant use of opioids. The aim of this trial was to examine the effect of intravenous (iv) acetaminophen compared with iv fentanyl on P2Y12 receptor inhibition in patients with STEMI. Methods and results The Opioids aNd crushed Ticagrelor In Myocardial infarction Evaluation (ON-TIME 3) trial randomized 195 STEMI patients who were scheduled to undergo primary percutaneous coronary intervention (PCI) and were pre-treated with crushed ticagrelor to iv acetaminophen (N = 98) or iv fentanyl (N = 97) in the ambulance. The primary endpoint, consisting of the level of platelet reactivity units (PRU) measured immediately after primary PCI, was not significantly different between the study arms [median PRU 104 (IQR 37–215) vs. 175 (63–228), P = 0.18]. However, systemic levels of ticagrelor were significantly higher in the acetaminophen arm at the start of primary PCI [151 ng/mL (32–509) vs. 60 ng/mL (13–206), P = 0.007], immediately after primary PCI [326 ng/mL (94–791) vs. 115 ng/mL (38–326), P = 0.002], and at 1 h after primary PCI [488 ng/mL (281–974) vs. 372 ng/mL (95–635), P = 0.002]. Acetaminophen resulted in the same extent of pain relief when compared with fentanyl [reduction of 3 points on 10-step-pain scale before primary PCI (IQR 1–5)] in both study arms (P = 0.67) and immediately after PCI [reduction of 5 points (3–7); P = 0.96]. Conclusion The iv acetaminophen in comparison with iv fentanyl was not associated with significantly lower platelet reactivity in STEMI patients but resulted in significantly higher ticagrelor plasma levels and was effective in pain relief.

Impact of vomiting on P2Y12 platelet inhibition in patients with ST-elevation myocardial infarction: A prespecified subanalysis of the ON-TIME 3 trial

2022 ◽  
Vol 243 ◽  
pp. 39-42
Author(s):  
Anne  H. Tavenier ◽  
Renicus  S. Hermanides ◽  
Jan  Paul. Ottervanger ◽  
Svetlana  V. Belitser ◽  
Olaf.  H. Klungel ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Platelet Inhibition ◽  
St Elevation Myocardial Infarction ◽  
St Elevation

scholarly journals 27 Use of rotational atherectomy in primary pci for st-elevation myocardial infarction- a single centre 10-year experience

Heart ◽  
2017 ◽  
Vol 103 (Suppl 5) ◽  
pp. A22.2-A23
Author(s):  
MM Mahmood ◽  
MA Qureshi ◽  
R Morley ◽  
D Austin ◽  
J Carter ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
St Elevation Myocardial Infarction ◽  
Rotational Atherectomy ◽  
Primary Pci ◽  
Single Centre ◽  
St Elevation

Direct Stenting Versus Stenting After Pre-dilation in Primary PCI for ST-Elevation Myocardial Infarction

2019 ◽  
Vol 28 ◽  
pp. S394
Author(s):  
V. Vijayarajan ◽  
A. Ekmejian ◽  
R. Cohen ◽  
S. Eather ◽  
A. Lee ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
St Elevation Myocardial Infarction ◽  
Primary Pci ◽  
Direct Stenting ◽  
St Elevation

scholarly journals Evaluation of a regional ST-elevation myocardial infarction primary percutaneous coronary intervention program at the Rouge Valley Health System

2021 ◽  
Author(s):  
Pria MD Nippak ◽  
Jodie Pritchard ◽  
Robin Horodyski ◽  
Candace J Ikeda-Douglas ◽  
Winston W Isaac
Keyword(s):  
Myocardial Infarction ◽  
Emergency Department ◽  
Percutaneous Coronary Intervention ◽  
Primary Percutaneous Coronary Intervention ◽  
Coronary Intervention ◽  
St Elevation Myocardial Infarction ◽  
Primary Pci ◽  
Percutaneous Coronary ◽  
St Elevation ◽  
Door To Balloon

Background ST-elevation myocardial infarction (STEMI) remains the second leading cause of death in Canada. Primary percutaneous coronary intervention (PCI) has been recognized as an effective method for treating STEMI. Improved access to primary PCI can be achieved through the implementation of regional PCI centres, which was the impetus for implementing the PCI program in an east Toronto hospital in 2009. As such, the purpose of this study was to measure the efficacy of this program regional expansion. Methods A retrospective review of 101 patients diagnosed with STEMI from May to Sept 2010 was conducted. The average door-to-balloon time for these STEMI patients was calculated and the door-to-balloon times using different methods of arrival were analyzed. Method of arrival was by one of three ways: paramedic initiated referral; patient walk-ins to PCI centre emergency department; or transfer after walk-in to community hospital emergency department. Results The study found that mean door-to balloon time for PCI was 112.5 minutes. When the door-to-balloon times were compared across the three arrival methods, patients who presented by paramedic-initiated referral had significantly shorter door-to-balloon times, (89.5 minutes) relative to those transferred (120.9 minutes) and those who walked into a PCI centre (126.7 minutes) (p = 0.047). Conclusions The findings suggest that the partnership between the hospital and its EMS partners should be continued, and paramedic initiated referral should be expanded across Canada and EMS systems where feasible, as this level of coverage does not currently exist nationwide. Investments in regional centres of excellence and the creation of EMS partnerships are needed to enhance access to primary PCI.

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