Publication
Title
Effect and safety of morphine use in acute anterior ST-segment elevation myocardial infarction
Author
Institution/Organisation
CIRCUS Study Investigators
Abstract
BackgroundMorphine is commonly used to treat chest pain during myocardial infarction, but its effect on cardiovascular outcome has never been directly evaluated. The aim of this study was to examine the effect and safety of morphine in patients with acute anterior ST-segment elevation myocardial infarction followed up for 1year. Methods and ResultsWe used the database of the CIRCUS (Does Cyclosporine Improve Outcome in ST Elevation Myocardial Infarction Patients) trial, which included 969 patients with anterior ST-segment elevation myocardial infarction, admitted for primary percutaneous coronary intervention. Two groups were defined according to use of morphine preceding coronary angiography. The composite primary outcome was the combined incidence of major adverse cardiovascular events, including cardiovascular death, heart failure, cardiogenic shock, myocardial infarction, unstable angina, and stroke during 1year. A total of 554 (57.1%) patients received morphine at first medical contact. Both groups, with and without morphine treatment, were comparable with respect to demographic and periprocedural characteristics. There was no significant difference in major adverse cardiovascular events between patients who received morphine compared with those who did not (26.2% versus 22.0%, respectively; P=0.15). The all-cause mortality was 5.3% in the morphine group versus 5.8% in the no-morphine group (P=0.89). There was no difference between groups in infarct size as assessed by the creatine kinase peak after primary percutaneous coronary intervention (4023118 versus 3903 +/- 149IU/L; P=0.52). ConclusionsIn anterior ST-segment elevation myocardial infarction patients treated by primary percutaneous coronary intervention, morphine was used in half of patients during initial management and was not associated with a significant increase in major adverse cardiovascular events at 1year.
Language
English
Source (journal)
Journal of the American Heart Association : Cardiovascular and cerebrovascular disease / American Heart Association; American Stroke Association. - [Hoboken, NJ], 2012, currens
Publication
[Hoboken, NJ] : John Wiley & Sons , 2018
ISSN
2047-9980
Volume/pages
7 :4 (2018) , 10 p.
Article Reference
e006833
ISI
000426644000004
Medium
E-only publicatie
Full text (Publisher's DOI)
Full text (open access)
UAntwerpen
Faculty/Department
Research group
Publication type
Subject
Affiliation
Publications with a UAntwerp address
External links
Web of Science
Record
Identification
Creation 29.03.2018
Last edited 15.10.2021
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