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Sökning: onr:"swepub:oai:DiVA.org:liu-153878" > Morphine and Ticagr...

Morphine and Ticagrelor Interaction in Primary Percutaneous Coronary Intervention in ST-Segment Elevation Myocardial Infarction : ATLANTIC-Morphine

Lapostolle, Frédéric (författare)
UF Recherche-Enseignement-Qualité, Université Paris, Hôpital Avicenne, Bobigny, France.
Van't Hof, Arnoud W (författare)
Department of Cardiology, Isala Clinics, Zwolle, The Netherlands, Maastricht University Medical Center, Maastricht, The Netherlands
Hamm, Christian W (författare)
Department of Cardiology, Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany
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Stibbe, Olivier (författare)
Service Médical d'Urgence, Brigade de Sapeurs-Pompiers de Paris, Paris, France
Ecollan, Patrick (författare)
Sorbonne Université, ACTION Study Group, Hôpital Pitié-Salpêtrière , Paris, France
Collet, Jean-Philippe (författare)
Sorbonne Université, ACTION Study Group, Hôpital Pitié-Salpêtrière , Paris, France
Silvain, Johanne (författare)
Sorbonne Université, ACTION Study Group, Hôpital Pitié-Salpêtrière , Paris, France
Lassen, Jens Flensted (författare)
Department of Cardiology B, Aarhus University Hospital, Skejby, Aarhus N, Denmark
Heutz, Wim M J M (författare)
Regionale Ambulance Voor ziening Gelderland-Midden, Arnhem, The Netherlands
Bolognese, Leonardo (författare)
Cardiovascular and Neurological Department, Azienda Ospedaliera Arezzo, Arezzo, Italy
Cantor, Warren J (författare)
Southlake Regional Health Centre, University of Toronto, Newmarket, ON, Canada
Cequier, Angel (författare)
Heart Disease Institute, Hospital Universitario de Bellvitge, University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain
Chettibi, Mohamed (författare)
Centre Hospito-universitaire Frantz Fanon, Blida, Algeria
Goodman, Shaun G (författare)
Division of Cardiology, Canadian Heart Research Centre, St Michael's Hospital, University of Toronto, Toronto, Canada
Hammett, Christopher J (författare)
Department of Cardiology, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia
Huber, Kurt (författare)
3rd Department of Medicine, Cardiology and Intensive Care Medicine, Wilhelminenhospital, Sigmund Freud University, Medical School, Vienna, Austria
Janzon, Magnus (författare)
Linköpings universitet,Avdelningen för kardiovaskulär medicin,Medicinska fakulteten,Region Östergötland, Kardiologiska kliniken US
Merkely, Béla (författare)
Heart and Vascular Center, Semmelweis University, Budapest, Hungary
Storey, Robert F (författare)
Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK
Ten Berg, Jur (författare)
Department of Cardiology, St Antonius Hospital Nieuwegein, Nieuwegein, The Netherlands
Zeymer, Uwe (författare)
Klinikum Ludwigshafen and Institut für Herzinfarktforschung Ludwigshafen, Ludwigshafen, Germany
Licour, Muriel (författare)
AstraZeneca, Rueil Malmaison, France
Tsatsaris, Anne (författare)
AstraZeneca, Rueil Malmaison, France
Montalescot, Gilles (författare)
Sorbonne Université, ACTION Study Group, Hôpital Pitié-Salpêtrière (AP-HP), 47 boul de l'Hôpital, Paris, France
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UF Recherche-Enseignement-Qualité, Université Paris, Hôpital Avicenne, Bobigny, France Department of Cardiology, Isala Clinics, Zwolle, The Netherlands, Maastricht University Medical Center, Maastricht, The Netherlands (creator_code:org_t)
2018-10-23
2019
Engelska.
Ingår i: American Journal of Cardiovascular Drugs. - Auckland, New Zealand : Adis International Ltd.. - 1175-3277 .- 1179-187X. ; 19, s. 173-183
Relaterad länk:
https://urn.kb.se/re...
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https://doi.org/10.1...
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  • Tidskriftsartikel (refereegranskat)
Abstract Ämnesord
Stäng  
  • BACKGROUND: Morphine adversely impacts the action of oral adenosine diphosphate (ADP)-receptor blockers in ST-segment elevation myocardial infarction (STEMI) patients, and is possibly associated with differing patient characteristics. This retrospective analysis investigated whether interaction between morphine use and pre-percutaneous coronary intervention (pre-PCI) ST-segment elevation resolution in STEMI patients in the ATLANTIC study was associated with differences in patient characteristics and management.METHODS: ATLANTIC was an international, multicenter, randomized study of treatment in the acute ambulance/hospital setting where STEMI patients received ticagrelor 180 mg ± morphine. Patient characteristics, cardiovascular history, risk factors, management, and outcomes were recorded.RESULTS: Opioids (97.6% morphine) were used in 921 out of 1862 patients (49.5%). There were no significant differences in age, sex or cardiovascular history, but more morphine-treated patients had anterior myocardial infarction and left-main disease. Time from chest pain to electrocardiogram and ticagrelor loading was shorter with morphine (both p = 0.01) but not total ischemic time. Morphine-treated patients more frequently received glycoprotein IIb/IIIa inhibitors (p = 0.002), thromboaspiration and stent implantation (both p < 0.001). No significant difference between the two groups was found regarding pre-PCI ≥ 70% ST-segment elevation resolution, death, myocardial infarction, stroke, urgent revascularization and definitive acute stent thrombosis. More morphine-treated patients had an absence of pre-PCI Thrombolysis in Myocardial Infarction (TIMI) 3 flow (85.8% vs. 79.7%; p = 0.001) and more had TIMI major bleeding (1.1% vs. 0.1%; p = 0.02).CONCLUSIONS: Morphine-treatment was associated with increased GP IIb/IIIa inhibitor use, less pre-PCI TIMI 3 flow, and more bleeding. Judicious morphine use is advised with non-opioid analgesics preferred for non-severe acute pain.TRIAL REGISTRATION: clinicaltrials.gov identifier: NCT01347580.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Kardiologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)

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