Status:

COMPLETED

The Effect of Opioids on P2Y12 Receptor Inhibition in Patients With ST-Elevation Myocardial Infarction Who Are Pre-treated With Crushed Ticagrelor

Lead Sponsor:

A.H. Tavenier

Collaborating Sponsors:

Isala

Conditions:

STEMI

STEMI - ST Elevation Myocardial Infarction

Eligibility:

All Genders

18+ years

Phase:

PHASE4

Brief Summary

Fast and accurate platelet inhibition is an important therapeutic goal in the acute treatment of patients with ST-segment elevation myocardial infarction (STEMI). Platelet inhibitory effects induced b...

Eligibility Criteria

Inclusion

  • i. age ≥18 years
  • ii. referred by ambulance paramedics to Isala (Zwolle) or Zuyderland Hospital (Heerlen)
  • iii. diagnosed in the ambulance with STEMI defined as:
  • ongoing chest pain \>30 minutes and \<12 hours duration and
  • ST-segment elevation \>0.1 milliVolt in at least 2 contiguous leads
  • iv. ongoing chest pain with a pain score (NRS) ≥4
  • v. the patient has been informed of the nature of the study, agrees to its provisions and has provided verbal informed consent in the pre-hospital phase followed by written informed consent in hospital

Exclusion

  • i. presenting with cardiogenic shock; defined as:
  • systolic blood pressure \<90 mmHg and
  • heart rate \>100/min and
  • peripheral oxygen saturation \<90% (without oxygen administration)
  • ii. patients with a nasogastric tube in situ or requiring a nasogastric tube
  • iii. patients who already received fentanyl or paracetamol \<2 hours prior to randomization
  • iv. patients on current treatment with P2Y12 inhibitors (ticagrelor, clopidogrel or prasugrel)
  • v. allergy to morphine or paracetamol
  • vi. patients with recent major bleeding complications or contraindication to dual antiplatelet therapy:
  • hypersensitivity to aspirin or ticagrelor
  • current use of (new) oral anticoagulation
  • history of bleeding diathesis or known coagulopathy
  • active bleeding
  • refusal of blood transfusions
  • history of intracerebral mass, aneurysm, arteriovenous malformation, or hemorrhagic stroke
  • known severe liver dysfunction
  • vii. received any organ transplant or is on a waiting list for any organ transplant
  • viii. patients undergoing dialysis
  • ix. pregnant or lactating female
  • x. patients currently participating in another investigational drug or device study

Key Trial Info

Start Date :

February 16 2018

Trial Type :

INTERVENTIONAL

Allocation :

ACTUAL

End Date :

November 22 2019

Estimated Enrollment :

200 Patients enrolled

Trial Details

Trial ID

NCT03400267

Start Date

February 16 2018

End Date

November 22 2019

Last Update

February 12 2020

Active Locations (1)

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1

Isala clinics

Zwolle, Netherlands