Effect and Safety of Morphine Use in Acute Anterior ST‐Segment Elevation Myocardial Infarction. Issue 4 (10th February 2018)

• Record Type: Journal Article
• Authors: Bonin, Mickael; Mewton, Nathan; Roubille, Francois; Morel, Olivier; Cayla, Guillaume; Angoulvant, Denis; Elbaz, Meyer; Claeys, Marc J.; Garcia‐Dorado, David; Giraud, Céline; Rioufol, Gilles; Jossan, Claire; Ovize, Michel; Guerin, Patrice
• Other Names: Bonnefoy‐Cudraz Eric investigator.; Delarche Nicolas investigator.; Coste Pierre investigator.; Vanzetto Gerald investigator.; Metge Marc investigator.; Aupetit Jean‐François investigator.; Jouve Bernard investigator.; Motreff Pascal investigator.; Tron Christophe investigator.; Labeque Jean‐Noel investigator.; Steg Philippe Gabriel investigator.; Cottin Yves investigator.; Range Grégoire investigator.; Clerc Jérome investigator.; Coussement Patrick investigator.; Prunier Fabrice investigator.; Moulin Frédéric investigator.; Roth Olivier investigator.; Belle Loïc investigator.; Dubois Philippe investigator.; Barragan Paul investigator.; Gilard Martine investigator.; Piot Christophe investigator.; Colin Patrice investigator.; De Poli Fabien investigator.; Morice Marie‐Claude investigator.; Ider Omar investigator.; Dubois‐Randé Jean‐Luc investigator.; Unterseeh Thierry investigator.; Le Breton Hervé investigator.; Béard Thierry investigator.; Blanchard Didier investigator.; Grollier Gilles investigator.; Malquarti Vincent investigator.; Staat Patrick investigator.; Sudre Arnaud investigator.; Elmer Eskil investigator.; Hansson Magnus J. investigator.; Bergerot Cyrille investigator.; Boussaha Inesse investigator.; Derumeaux Geneviève investigator.;
• Is Part Of: Journal of the American Heart Association. Volume 7:Issue 4(2018)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2018-02-10
• Subjects: clinical -- morphine -- opioid -- percutaneous coronary intervention -- pharmaceutical safety -- ST‐segment elevation myocardial infarction; Heart -- Diseases -- Periodicals; Cardiovascular system -- Diseases -- Periodicals; Cerebrovascular disease -- Periodicals; Cardiology -- Periodicals; 616.1
• DOI: 10.1161/JAHA.117.006833
• Languages: English
• ISSNs: 2047-9980

Abstract

Abstract : Background: Morphine 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 1 year. Methods and Results: We 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 1 year. 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 (4023±118 versus 3903±149 IU/L; P =0.52). Conclusions: In 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 1 year.