Crushing ticagrelor made no significant differences in platelet reactivity when administered with fentanyl to patients undergoing percutaneous coronary intervention (PCI) in the single-center FACT PCI trial. The findings from the 38-patient randomized controlled trial were reported Monday morning in a Late-Breaking Clinical Science session at Cardiovascular Research Technologies (CRT) 2025, by Asna Afreen, MD, from Harvard Medical School, Boston. FACT (Fentanyl and Crushed Ticagrelor) PCI was set up following literature suggesting that the opioid fentanyl decreases the antiplatelet effect of ticagrelor, and that crushed ticagrelor (CT) has more effective antiplatelet action than non-crushed/ whole ticagrelor (NCT) due to rapid absorption. The 38 patients in the study were randomized to receive either CT + fentanyl (n = 15) or NCT + fentanyl (n =23). Platelet Reactivity Unit (PRU) was measured at the baseline, 30 minutes, 2 hours and four hours. Chi Square test was done to compare categorical outcomes while Wilcoxon test was used to compare the continuous outcomes between two groups, the researchers of the study said. They found no statistically significant differences in the baseline demographic distribution or co-morbidities between the two groups (all p>0.05), while PRUs obtained at different time intervals were similar in magnitude across both groups (p>0.05). No incidences of in-hospital mortality, 30-day stent-thrombosis, stroke or mortality were reported in either of the groups. There was also no significant difference in the proportion of patients readmitted within 30 days in either group (9.1% vs 13.3%, p=0.683). And while NCT had a higher proportion of patients with MI within 30 days, it was not statistically significant (8.7% vs 0%, p=0.241). Overall, patients undergoing PCI who were given ticagrelor with fentanyl showed no significant differences in platelet reactivity when ticagrelor was crushed versus uncrushed. Image Credit: Bailey G. Salimes, CRTonline.org Image Caption: Asna Afreen, MD, presents during a Late-Breaking Clinical Science session at Cardiovascular Research Technologies (CRT) 2025 on Monday.