Key result
Morphine administration did not have a protective effect against the development of in-hospital complications after acute myocardial infarction (OR 1.02).
Why the study?
Guidelines recommend morphine as the drug of choice for severe chest pain in AMI, but its effect alongside chest pain on complication rates required evaluation.
Does morphine administration reduce in-hospital complications in patients with STEMI?
Observational (n=300)
Yes
Does morphine administration reduce in-hospital complications in patients with STEMI?
Odds Ratio: 1.02 (95% CI 0.57–1.64)
p-value: p=0.76
In patients with STEMI, morphine administration in the emergency department did not protect against in-hospital complications, whereas severe and prolonged chest pain were independent predictors of adverse events.
No support for morphine in preventing post-AMI complications from observational data; leaves open need for RCTs to guide practice.
Background: Patients with Acute Myocardial Infarction (AMI) are usually present complaining of severe chest pain. This pain results from an imbalance between oxygen supply and demand, leading to severe complications. Different guidelines recommend using Morphine as a drug of choice for treating this pain. Objective: This study aimed to check the effect of chest pain and Morphine use on complications rate after AMI. Methods: This was a prospective observational study with a consecutive sample of 300 patients with AMI. Data were collected by direct patients interview and medical records review in the emergency departments & Intensive Care Units (ICU). Any complication developed within the hospital stay and after AMI was recorded. All correlated variables were analyzed using the binary logistic regression model. Results: The sample included 176 (58.7%) men and 124 (41.3%) women with a mean age of 56.92±12.13 years. A total of 83 patients (27.7%) developed one or more in-hospital complications. Acute recurrent ischemia was the most frequent complication; 70 (23.3%). Severe chest pain (≥ 7), duration of chest pain (more than 5 minutes), history of previous MI, and history of hypertension increased the occurrence of complications by 13%, 7%, 63%, and 25%, respectively. However, the use of Morphine did not have any protective effect against the development of these complications. Conclusion: The severity and duration of chest pain increased the occurrence of complications. Morphine administration did not have any protective effect against the development of these complications. Thus, it is recommended to update different policies and guidelines to use other types of chest pain relief methods, e.g ., treating the underlying cause of chest pain and addressing the imbalance between oxygen supply and demand.
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Taha et al. (2022) conducted an observational in Acute Myocardial Infarction (STEMI) (n=300). Morphine use vs. No morphine use was evaluated on In-hospital complications (OR 1.02, 95% CI 0.57-1.64, p=0.76). Morphine administration did not have a protective effect against the development of in-hospital complications after acute myocardial infarction (OR 1.02).
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