Trial Outcomes & Findings for Fentanyl and Crushed Ticagrelor in Percutaneous Coronary Intervention (NCT NCT03476369)

NCT ID: NCT03476369

Last Updated: 2026-02-04

Results Overview

The Platelet Function Testing assay will be VerifyNow Platelet Reactivity Assay which is used institutionally. Results are reported in platelet reactive units (PRUs). Based on previous studies, 208 will be used as an estimated cutoff to distinguish therapeutic and subtherapeutic platelet inhibition, with PRUs equal to or less than 208 being considered therapeutic

Recruitment status

TERMINATED

Study phase

PHASE4

Target enrollment

45 participants

Primary outcome timeframe

6 hours after the loading dose of Ticagrelor

Results posted on

2026-02-04

Participant Flow

Participant milestones

Participant milestones
Measure
Fentanyl and Crushed Ticagrelor
Premedicated with Fentanyl (at least 25mcg by IV) followed by Ticagrelor 90mg tablet administered crushed (180 mg dose) Fentanyl: Premedicated with Fentanyl (at least 25mcg by IV) Ticagrelor 90Mg Tablet: Ticagrelor administered crushed vs non-crushed
Fentanyl and Non-crushed Ticagrelor
Premedicated with Fentanyl (at least 25mcg by IV) followed by Ticagrelor 90mg tablet administered as a whole tablet (180 mg dose) Fentanyl: Premedicated with Fentanyl (at least 25mcg by IV) Ticagrelor 90Mg Tablet: Ticagrelor administered crushed vs non-crushed
Overall Study
STARTED
20
25
Overall Study
COMPLETED
16
22
Overall Study
NOT COMPLETED
4
3

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Fentanyl and Crushed Ticagrelor in Percutaneous Coronary Intervention

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Fentanyl and Crushed Ticagrelor
n=16 Participants
Premedicated with Fentanyl (at least 25mcg by IV) followed by Ticagrelor 90mg tablet administered crushed (180 mg dose) Fentanyl: Premedicated with Fentanyl (at least 25mcg by IV) Ticagrelor 90Mg Tablet: Ticagrelor administered crushed vs non-crushed
Fentanyl and Non-crushed Ticagrelor
n=22 Participants
Premedicated with Fentanyl (at least 25mcg by IV) followed by Ticagrelor 90mg tablet administered as a whole tablet (180 mg dose) Fentanyl: Premedicated with Fentanyl (at least 25mcg by IV) Ticagrelor 90Mg Tablet: Ticagrelor administered crushed vs non-crushed
Total
n=38 Participants
Total of all reporting groups
Age, Continuous
65.19 years
STANDARD_DEVIATION 9.58 • n=25 Participants
68.50 years
STANDARD_DEVIATION 8.84 • n=26 Participants
67.11 years
STANDARD_DEVIATION 9.18 • n=51 Participants
Sex: Female, Male
Female
3 Participants
n=25 Participants
6 Participants
n=26 Participants
9 Participants
n=51 Participants
Sex: Female, Male
Male
13 Participants
n=25 Participants
16 Participants
n=26 Participants
29 Participants
n=51 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=25 Participants
0 Participants
n=26 Participants
0 Participants
n=51 Participants
Race (NIH/OMB)
Asian
0 Participants
n=25 Participants
0 Participants
n=26 Participants
0 Participants
n=51 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=25 Participants
0 Participants
n=26 Participants
0 Participants
n=51 Participants
Race (NIH/OMB)
Black or African American
1 Participants
n=25 Participants
0 Participants
n=26 Participants
1 Participants
n=51 Participants
Race (NIH/OMB)
White
15 Participants
n=25 Participants
22 Participants
n=26 Participants
37 Participants
n=51 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=25 Participants
0 Participants
n=26 Participants
0 Participants
n=51 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants
n=25 Participants
0 Participants
n=26 Participants
0 Participants
n=51 Participants
Region of Enrollment
United States
16 participants
n=25 Participants
22 participants
n=26 Participants
38 participants
n=51 Participants
Body Mass Index (BMI)
31.93 kilograms per square meter
STANDARD_DEVIATION 7.47 • n=25 Participants
31.68 kilograms per square meter
STANDARD_DEVIATION 5.76 • n=26 Participants
31.79 kilograms per square meter
STANDARD_DEVIATION 6.43 • n=51 Participants
Smoking status = Former/Current Smoker
13 Participants
n=25 Participants
13 Participants
n=26 Participants
26 Participants
n=51 Participants
Diabetes
8 Participants
n=25 Participants
9 Participants
n=26 Participants
17 Participants
n=51 Participants
Hypertension
10 Participants
n=25 Participants
18 Participants
n=26 Participants
28 Participants
n=51 Participants
Hyperlipidemia
10 Participants
n=25 Participants
17 Participants
n=26 Participants
27 Participants
n=51 Participants
Coronary Artery Disease
11 Participants
n=25 Participants
14 Participants
n=26 Participants
25 Participants
n=51 Participants
Gastroesophageal Reflux Disease (GERD)
4 Participants
n=25 Participants
8 Participants
n=26 Participants
12 Participants
n=51 Participants
Obstructive Sleep Apnea (OSA)
2 Participants
n=25 Participants
1 Participants
n=26 Participants
3 Participants
n=51 Participants
Positive Imaging Study
7 Participants
n=25 Participants
12 Participants
n=26 Participants
19 Participants
n=51 Participants
Prior Myocardial Infarction (MI) at Admission
7 Participants
n=25 Participants
9 Participants
n=26 Participants
16 Participants
n=51 Participants
Renal Insufficiency
1 Participants
n=25 Participants
2 Participants
n=26 Participants
3 Participants
n=51 Participants
Non-Elective Procedure
7 Participants
n=25 Participants
8 Participants
n=26 Participants
15 Participants
n=51 Participants
Primary Procedure Angioplasty Stent Coronary
16 Participants
n=25 Participants
21 Participants
n=26 Participants
37 Participants
n=51 Participants
Length of Surgery
1.46 Hours
n=25 Participants
1.40 Hours
n=26 Participants
1.42 Hours
n=51 Participants

PRIMARY outcome

Timeframe: 6 hours after the loading dose of Ticagrelor

Population: Not all participants had a test completed at every time.

The Platelet Function Testing assay will be VerifyNow Platelet Reactivity Assay which is used institutionally. Results are reported in platelet reactive units (PRUs). Based on previous studies, 208 will be used as an estimated cutoff to distinguish therapeutic and subtherapeutic platelet inhibition, with PRUs equal to or less than 208 being considered therapeutic

Outcome measures

Outcome measures
Measure
Fentanyl and Crushed Ticagrelor
n=9 Participants
Premedicated with Fentanyl (at least 25mcg by IV) followed by Ticagrelor 90mg tablet administered crushed (180 mg dose) Fentanyl: Premedicated with Fentanyl (at least 25mcg by IV) Ticagrelor 90Mg Tablet: Ticagrelor administered crushed vs non-crushed
Fentanyl and Non-crushed Ticagrelor
n=12 Participants
Premedicated with Fentanyl (at least 25mcg by IV) followed by Ticagrelor 90mg tablet administered as a whole tablet (180 mg dose) Fentanyl: Premedicated with Fentanyl (at least 25mcg by IV) Ticagrelor 90Mg Tablet: Ticagrelor administered crushed vs non-crushed
Area Under the Platelet Function Testing (PFT)-Time Curve (AUC0-6) for the First 6 Hours After the Loading Dose of Ticagrelor
796.34 Platelet Reactive Units (PRUs)/hour
Interval 420.23 to 950.36
622.37 Platelet Reactive Units (PRUs)/hour
Interval 439.28 to 712.04

SECONDARY outcome

Timeframe: From time of procedure until hospital discharge, up to 3 days

Stent thrombosis while in hospital from time of procedure until discharge

Outcome measures

Outcome measures
Measure
Fentanyl and Crushed Ticagrelor
n=16 Participants
Premedicated with Fentanyl (at least 25mcg by IV) followed by Ticagrelor 90mg tablet administered crushed (180 mg dose) Fentanyl: Premedicated with Fentanyl (at least 25mcg by IV) Ticagrelor 90Mg Tablet: Ticagrelor administered crushed vs non-crushed
Fentanyl and Non-crushed Ticagrelor
n=22 Participants
Premedicated with Fentanyl (at least 25mcg by IV) followed by Ticagrelor 90mg tablet administered as a whole tablet (180 mg dose) Fentanyl: Premedicated with Fentanyl (at least 25mcg by IV) Ticagrelor 90Mg Tablet: Ticagrelor administered crushed vs non-crushed
In-Hospital Stent Thrombosis
0 Participants
0 Participants

SECONDARY outcome

Timeframe: From time of procedure until hospital discharge, up to 3 days

TIMI bleeding is a standardized clinical trial classification used to grade bleeding severity in cardiovascular studies. TIMI major bleeding: Any intracranial hemorrhage, or clinically overt bleeding with a ≥5 g/dL decrease in hemoglobin (or ≥15% absolute drop in hematocrit). TIMI minor bleeding: Clinically overt bleeding associated with a 3 to \<5 g/dL decrease in hemoglobin (or 10 to \<15% absolute drop in hematocrit). The measure will assess any participant who had at least a 3 g/dL drop in hemoglobin.

Outcome measures

Outcome measures
Measure
Fentanyl and Crushed Ticagrelor
n=16 Participants
Premedicated with Fentanyl (at least 25mcg by IV) followed by Ticagrelor 90mg tablet administered crushed (180 mg dose) Fentanyl: Premedicated with Fentanyl (at least 25mcg by IV) Ticagrelor 90Mg Tablet: Ticagrelor administered crushed vs non-crushed
Fentanyl and Non-crushed Ticagrelor
n=22 Participants
Premedicated with Fentanyl (at least 25mcg by IV) followed by Ticagrelor 90mg tablet administered as a whole tablet (180 mg dose) Fentanyl: Premedicated with Fentanyl (at least 25mcg by IV) Ticagrelor 90Mg Tablet: Ticagrelor administered crushed vs non-crushed
In-Hospital Thrombolysis in Myocardial Infarction (TIMI) Major and Minor Bleeding
0 Participants
0 Participants

SECONDARY outcome

Timeframe: From time of procedure until hospital discharge, up to 3 days

Myocardial Infarction while in hospital from time of procedure until discharge

Outcome measures

Outcome measures
Measure
Fentanyl and Crushed Ticagrelor
n=16 Participants
Premedicated with Fentanyl (at least 25mcg by IV) followed by Ticagrelor 90mg tablet administered crushed (180 mg dose) Fentanyl: Premedicated with Fentanyl (at least 25mcg by IV) Ticagrelor 90Mg Tablet: Ticagrelor administered crushed vs non-crushed
Fentanyl and Non-crushed Ticagrelor
n=22 Participants
Premedicated with Fentanyl (at least 25mcg by IV) followed by Ticagrelor 90mg tablet administered as a whole tablet (180 mg dose) Fentanyl: Premedicated with Fentanyl (at least 25mcg by IV) Ticagrelor 90Mg Tablet: Ticagrelor administered crushed vs non-crushed
In-Hospital Recurrent Myocardial Infarction
0 Participants
0 Participants

SECONDARY outcome

Timeframe: From time of procedure until hospital discharge, up to 3 days

Stroke while in hospital from time of procedure until discharge

Outcome measures

Outcome measures
Measure
Fentanyl and Crushed Ticagrelor
n=16 Participants
Premedicated with Fentanyl (at least 25mcg by IV) followed by Ticagrelor 90mg tablet administered crushed (180 mg dose) Fentanyl: Premedicated with Fentanyl (at least 25mcg by IV) Ticagrelor 90Mg Tablet: Ticagrelor administered crushed vs non-crushed
Fentanyl and Non-crushed Ticagrelor
n=22 Participants
Premedicated with Fentanyl (at least 25mcg by IV) followed by Ticagrelor 90mg tablet administered as a whole tablet (180 mg dose) Fentanyl: Premedicated with Fentanyl (at least 25mcg by IV) Ticagrelor 90Mg Tablet: Ticagrelor administered crushed vs non-crushed
In-Hospital Stroke
0 Participants
0 Participants

SECONDARY outcome

Timeframe: From time of procedure until hospital discharge, up to 3 days

Death while in hospital from time of procedure until discharge

Outcome measures

Outcome measures
Measure
Fentanyl and Crushed Ticagrelor
n=16 Participants
Premedicated with Fentanyl (at least 25mcg by IV) followed by Ticagrelor 90mg tablet administered crushed (180 mg dose) Fentanyl: Premedicated with Fentanyl (at least 25mcg by IV) Ticagrelor 90Mg Tablet: Ticagrelor administered crushed vs non-crushed
Fentanyl and Non-crushed Ticagrelor
n=22 Participants
Premedicated with Fentanyl (at least 25mcg by IV) followed by Ticagrelor 90mg tablet administered as a whole tablet (180 mg dose) Fentanyl: Premedicated with Fentanyl (at least 25mcg by IV) Ticagrelor 90Mg Tablet: Ticagrelor administered crushed vs non-crushed
In-Hospital Death
0 Participants
0 Participants

SECONDARY outcome

Timeframe: 30 days after hospital discharge

Stent Thrombosis within 30 days from hospital discharge

Outcome measures

Outcome measures
Measure
Fentanyl and Crushed Ticagrelor
n=16 Participants
Premedicated with Fentanyl (at least 25mcg by IV) followed by Ticagrelor 90mg tablet administered crushed (180 mg dose) Fentanyl: Premedicated with Fentanyl (at least 25mcg by IV) Ticagrelor 90Mg Tablet: Ticagrelor administered crushed vs non-crushed
Fentanyl and Non-crushed Ticagrelor
n=22 Participants
Premedicated with Fentanyl (at least 25mcg by IV) followed by Ticagrelor 90mg tablet administered as a whole tablet (180 mg dose) Fentanyl: Premedicated with Fentanyl (at least 25mcg by IV) Ticagrelor 90Mg Tablet: Ticagrelor administered crushed vs non-crushed
30-Day Stent Thrombosis
1 Participants
0 Participants

SECONDARY outcome

Timeframe: 30 days after hospital discharge

TIMI bleeding is a standardized clinical trial classification used to grade bleeding severity in cardiovascular studies. TIMI major bleeding: Any intracranial hemorrhage, or clinically overt bleeding with a ≥5 g/dL decrease in hemoglobin (or ≥15% absolute drop in hematocrit). TIMI minor bleeding: Clinically overt bleeding associated with a 3 to \<5 g/dL decrease in hemoglobin (or 10 to \<15% absolute drop in hematocrit). The measure will assess any participant who had at least a 3 g/dL drop in hemoglobin.

Outcome measures

Outcome measures
Measure
Fentanyl and Crushed Ticagrelor
n=16 Participants
Premedicated with Fentanyl (at least 25mcg by IV) followed by Ticagrelor 90mg tablet administered crushed (180 mg dose) Fentanyl: Premedicated with Fentanyl (at least 25mcg by IV) Ticagrelor 90Mg Tablet: Ticagrelor administered crushed vs non-crushed
Fentanyl and Non-crushed Ticagrelor
n=22 Participants
Premedicated with Fentanyl (at least 25mcg by IV) followed by Ticagrelor 90mg tablet administered as a whole tablet (180 mg dose) Fentanyl: Premedicated with Fentanyl (at least 25mcg by IV) Ticagrelor 90Mg Tablet: Ticagrelor administered crushed vs non-crushed
30-Day TIMI Major and Minor Bleeding
0 Participants
0 Participants

SECONDARY outcome

Timeframe: 30 days after hospital discharge

Recurrent myocardial infarction within 30 days after hospital discharge.

Outcome measures

Outcome measures
Measure
Fentanyl and Crushed Ticagrelor
n=16 Participants
Premedicated with Fentanyl (at least 25mcg by IV) followed by Ticagrelor 90mg tablet administered crushed (180 mg dose) Fentanyl: Premedicated with Fentanyl (at least 25mcg by IV) Ticagrelor 90Mg Tablet: Ticagrelor administered crushed vs non-crushed
Fentanyl and Non-crushed Ticagrelor
n=22 Participants
Premedicated with Fentanyl (at least 25mcg by IV) followed by Ticagrelor 90mg tablet administered as a whole tablet (180 mg dose) Fentanyl: Premedicated with Fentanyl (at least 25mcg by IV) Ticagrelor 90Mg Tablet: Ticagrelor administered crushed vs non-crushed
30-Day Recurrent Myocardial Infarction
1 Participants
2 Participants

SECONDARY outcome

Timeframe: 30 days after hospital disharge

Stroke within 30 days after hospital discharge

Outcome measures

Outcome measures
Measure
Fentanyl and Crushed Ticagrelor
n=16 Participants
Premedicated with Fentanyl (at least 25mcg by IV) followed by Ticagrelor 90mg tablet administered crushed (180 mg dose) Fentanyl: Premedicated with Fentanyl (at least 25mcg by IV) Ticagrelor 90Mg Tablet: Ticagrelor administered crushed vs non-crushed
Fentanyl and Non-crushed Ticagrelor
n=22 Participants
Premedicated with Fentanyl (at least 25mcg by IV) followed by Ticagrelor 90mg tablet administered as a whole tablet (180 mg dose) Fentanyl: Premedicated with Fentanyl (at least 25mcg by IV) Ticagrelor 90Mg Tablet: Ticagrelor administered crushed vs non-crushed
30-Day Stroke
0 Participants
0 Participants

SECONDARY outcome

Timeframe: 30 days after hospital discharge

Death within 30 days after hospital discharge

Outcome measures

Outcome measures
Measure
Fentanyl and Crushed Ticagrelor
n=16 Participants
Premedicated with Fentanyl (at least 25mcg by IV) followed by Ticagrelor 90mg tablet administered crushed (180 mg dose) Fentanyl: Premedicated with Fentanyl (at least 25mcg by IV) Ticagrelor 90Mg Tablet: Ticagrelor administered crushed vs non-crushed
Fentanyl and Non-crushed Ticagrelor
n=22 Participants
Premedicated with Fentanyl (at least 25mcg by IV) followed by Ticagrelor 90mg tablet administered as a whole tablet (180 mg dose) Fentanyl: Premedicated with Fentanyl (at least 25mcg by IV) Ticagrelor 90Mg Tablet: Ticagrelor administered crushed vs non-crushed
30-Day All-cause Mortality (Death)
0 Participants
0 Participants

OTHER_PRE_SPECIFIED outcome

Timeframe: From admission for the procedure until discharge, assessed up to 3 days

Time (Hours) in the hospital from admission for the procedure until discharge

Outcome measures

Outcome measures
Measure
Fentanyl and Crushed Ticagrelor
n=16 Participants
Premedicated with Fentanyl (at least 25mcg by IV) followed by Ticagrelor 90mg tablet administered crushed (180 mg dose) Fentanyl: Premedicated with Fentanyl (at least 25mcg by IV) Ticagrelor 90Mg Tablet: Ticagrelor administered crushed vs non-crushed
Fentanyl and Non-crushed Ticagrelor
n=22 Participants
Premedicated with Fentanyl (at least 25mcg by IV) followed by Ticagrelor 90mg tablet administered as a whole tablet (180 mg dose) Fentanyl: Premedicated with Fentanyl (at least 25mcg by IV) Ticagrelor 90Mg Tablet: Ticagrelor administered crushed vs non-crushed
Hospital Length of Stay
27.00 Hours
Interval 23.0 to 40.0
28.50 Hours
Interval 22.25 to 48.75

OTHER_PRE_SPECIFIED outcome

Timeframe: 30 days after hospital discharge

Readmission to the hospital within 30 days of discharge

Outcome measures

Outcome measures
Measure
Fentanyl and Crushed Ticagrelor
n=16 Participants
Premedicated with Fentanyl (at least 25mcg by IV) followed by Ticagrelor 90mg tablet administered crushed (180 mg dose) Fentanyl: Premedicated with Fentanyl (at least 25mcg by IV) Ticagrelor 90Mg Tablet: Ticagrelor administered crushed vs non-crushed
Fentanyl and Non-crushed Ticagrelor
n=22 Participants
Premedicated with Fentanyl (at least 25mcg by IV) followed by Ticagrelor 90mg tablet administered as a whole tablet (180 mg dose) Fentanyl: Premedicated with Fentanyl (at least 25mcg by IV) Ticagrelor 90Mg Tablet: Ticagrelor administered crushed vs non-crushed
30-Day Hospital Readmission
0 Participants
1 Participants

Adverse Events

Fentanyl and Crushed Ticagrelor

Serious events: 2 serious events
Other events: 0 other events
Deaths: 0 deaths

Fentanyl and Non-crushed Ticagrelor

Serious events: 2 serious events
Other events: 0 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Fentanyl and Crushed Ticagrelor
n=16 participants at risk
Premedicated with Fentanyl (at least 25mcg by IV) followed by Ticagrelor 90mg tablet administered crushed (180 mg dose) Fentanyl: Premedicated with Fentanyl (at least 25mcg by IV) Ticagrelor 90Mg Tablet: Ticagrelor administered crushed vs non-crushed
Fentanyl and Non-crushed Ticagrelor
n=22 participants at risk
Premedicated with Fentanyl (at least 25mcg by IV) followed by Ticagrelor 90mg tablet administered as a whole tablet (180 mg dose) Fentanyl: Premedicated with Fentanyl (at least 25mcg by IV) Ticagrelor 90Mg Tablet: Ticagrelor administered crushed vs non-crushed
Cardiac disorders
Stent Thrombosis
6.2%
1/16 • Number of events 1 • 30 days after hospital discharge
0.00%
0/22 • 30 days after hospital discharge
Blood and lymphatic system disorders
TIMI bleeding
0.00%
0/16 • 30 days after hospital discharge
0.00%
0/22 • 30 days after hospital discharge
Cardiac disorders
Myocardial Infarction
6.2%
1/16 • Number of events 1 • 30 days after hospital discharge
9.1%
2/22 • Number of events 2 • 30 days after hospital discharge
Nervous system disorders
Stroke
0.00%
0/16 • 30 days after hospital discharge
0.00%
0/22 • 30 days after hospital discharge

Other adverse events

Adverse event data not reported

Additional Information

Sudhakar Sattur MD, Principal Investigator

The Guthrie Clinic

Phone: 570-887-4882

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place