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  • Lapostolle, FrédéricUF Recherche-Enseignement-Qualité, Université Paris, Hôpital Avicenne, Bobigny, France. (författare)

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

  • Artikel/kapitelEngelska2019

Förlag, utgivningsår, omfång ...

  • Auckland, New Zealand :Adis International Ltd.2019
  • printrdacarrier

Nummerbeteckningar

  • LIBRIS-ID:oai:DiVA.org:liu-153878
  • urn:nbn:se:liu:diva-153878urn
  • https://doi.org/10.1007/s40256-018-0305-0DOI

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  • Språk:engelska
  • Sammanfattning på:engelska

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  • Ämneskategori:ref swepub-contenttype
  • Ämneskategori:art swepub-publicationtype

Anmärkningar

  • 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 och genrebeteckningar

Biuppslag (personer, institutioner, konferenser, titlar ...)

  • Van't Hof, Arnoud WDepartment of Cardiology, Isala Clinics, Zwolle, The Netherlands, Maastricht University Medical Center, Maastricht, The Netherlands (författare)
  • Hamm, Christian WDepartment of Cardiology, Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany (författare)
  • Stibbe, OlivierService Médical d'Urgence, Brigade de Sapeurs-Pompiers de Paris, Paris, France (författare)
  • Ecollan, PatrickSorbonne Université, ACTION Study Group, Hôpital Pitié-Salpêtrière , Paris, France (författare)
  • Collet, Jean-PhilippeSorbonne Université, ACTION Study Group, Hôpital Pitié-Salpêtrière , Paris, France (författare)
  • Silvain, JohanneSorbonne Université, ACTION Study Group, Hôpital Pitié-Salpêtrière , Paris, France (författare)
  • Lassen, Jens FlenstedDepartment of Cardiology B, Aarhus University Hospital, Skejby, Aarhus N, Denmark (författare)
  • Heutz, Wim M J MRegionale Ambulance Voor ziening Gelderland-Midden, Arnhem, The Netherlands (författare)
  • Bolognese, LeonardoCardiovascular and Neurological Department, Azienda Ospedaliera Arezzo, Arezzo, Italy (författare)
  • Cantor, Warren JSouthlake Regional Health Centre, University of Toronto, Newmarket, ON, Canada (författare)
  • Cequier, AngelHeart Disease Institute, Hospital Universitario de Bellvitge, University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain (författare)
  • Chettibi, MohamedCentre Hospito-universitaire Frantz Fanon, Blida, Algeria (författare)
  • Goodman, Shaun GDivision of Cardiology, Canadian Heart Research Centre, St Michael's Hospital, University of Toronto, Toronto, Canada (författare)
  • Hammett, Christopher JDepartment of Cardiology, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia (författare)
  • Huber, Kurt3rd Department of Medicine, Cardiology and Intensive Care Medicine, Wilhelminenhospital, Sigmund Freud University, Medical School, Vienna, Austria (författare)
  • Janzon, MagnusLinköpings universitet,Avdelningen för kardiovaskulär medicin,Medicinska fakulteten,Region Östergötland, Kardiologiska kliniken US(Swepub:liu)magja75 (författare)
  • Merkely, BélaHeart and Vascular Center, Semmelweis University, Budapest, Hungary (författare)
  • Storey, Robert FDepartment of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK (författare)
  • Ten Berg, JurDepartment of Cardiology, St Antonius Hospital Nieuwegein, Nieuwegein, The Netherlands (författare)
  • Zeymer, UweKlinikum Ludwigshafen and Institut für Herzinfarktforschung Ludwigshafen, Ludwigshafen, Germany (författare)
  • Licour, MurielAstraZeneca, Rueil Malmaison, France (författare)
  • Tsatsaris, AnneAstraZeneca, Rueil Malmaison, France (författare)
  • Montalescot, GillesSorbonne Université, ACTION Study Group, Hôpital Pitié-Salpêtrière (AP-HP), 47 boul de l'Hôpital, Paris, France (författare)
  • 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)

Sammanhörande titlar

  • Ingår i:American Journal of Cardiovascular DrugsAuckland, New Zealand : Adis International Ltd.19, s. 173-1831175-32771179-187X

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