Influence of METHoxyflurane on ANtiplatelet Effect of ticagrelor in patients with unstable angina pectoris: Rationale and a protocol of a randomized clinical METHANE-SIRIO 4 study

Does ticagrelor effectively inhibit platelets in patients undergoing mild therapeutic hypothermia or it does not?

“…Several factors, including patient age, baseline heart rhythm and neurological status, presence of cardiogenic shock, duration and effectiveness of cardiopulmonary resuscitation and hypothermia induction time were shown to influence clinical outcome in patients after OHCA treated with MTH [9,[15][16][17][18][19][20]. In patients additionally undergoing primary percutaneous coronary intervention (pPCI) due to MI, effective platelet inhibition may also have a relevant impact on clinical outcome due to increased risk of stent thrombosis in this subset of patients [21][22][23][24][25][26][27][28][29][30][31][32].…”

Opioids and oral P2Y12 receptor inhibitors: A drug–drug interaction

“…In a metaanalysis by Gue et al [10], patients pretreated with morphine were shown to have a higher rate of reinfarction than those not receiving morphine. Several approaches to overcome the "morphine effect" in patients with ACS have been proposed, showing some, but unsatisfactory effects [11][12][13][14][15][16]. Iglesias et al [17] reported results of the PERSEUS studya randomized trial comparing the impact of fentanyl versus morphine on ticagrelor pharmacokinetics and pharmacodynamics in STEMI patients undergoing primary percutaneous coronary intervention (PCI).…”

Mild therapeutic hypothermia or targeted temperature management for cardiac arrest survivors?

“…Acute coronary syndrome is the most common cause of OHCA [17]. In this context, when planning a new trial, the routine use of cangrelor in patients undergoing MTH should be considered due to the diminished antiplatelet effect of oral P2Y12 inhibitors [18][19][20][21][22].…”