Why is this study important? 

• Multiple studies have shown that opiates such as fentanyl can reduce the antiplatelet efficacy of P2Y12 inhibitors by reducing GI transit and absorption. 

• Previous studies have also shown that crushed Ticagrelor resulted in significantly better early platelet inhibition than the traditional oral administration. 

What question was this study supposed to answer? 

• The current study compared the anti-platelet efficacy and its associated cardiovascular outcomes using crushed Ticagrelor (CT) versus non-crushed Ticagrelor (NCT) in patients undergoing percutaneous coronary intervention (PCI) and who received fentanyl for conscious sedation during the procedure. 
• The study outcomes for the two groups were compared using Chi square and Wilcoxon tests. They are as below respectively: 
  • The Platelet Reactivity Unit (PRU) measured at baseline, 30 minutes, 2 hours, and 4 hours. 
  • In-hospital mortality, 30-day stent-thrombosis, stroke, and mortality. 

What did the study show? 

• This was a single center randomized control trial involving thirty-eight patients. 
• The two groups had 15 (CT) and 23 (NCT) patients, respectively. Both received fentanyl for conscious sedation. 
• There was no statistically significant difference in the outcomes between the two groups CT and NCT (p>0.05): 
  • PRU’s obtained were similar in magnitude across both groups. 
  • In-hospital mortality, 30-day stent-thrombosis, stroke and mortality were similar between the two groups. 

In conclusion, in this single center randomized control trial done on thirty-eight patients undergoing PCI, there was no significant difference in the antiplatelet efficacy and its associated cardiovascular outcomes with administration of fentanyl either with crushed Ticagrelor or non-crushed Ticagrelor.