Morphine and Ticagrelor Interaction in Primary Percutaneous Coronary Intervention in ST-Segment Elevation Myocardial Infarction: ATLANTIC-Morphine
Why the study?
Does morphine use affect pre-PCI ST-segment elevation resolution and clinical outcomes in STEMI patients receiving ticagrelor?
Population
1,862 STEMI patients in the acute ambulance/hospital setting undergoing primary percutaneous coronary…
Comparison
Morphine in addition to ticagrelor 180 mg… vs Ticagrelor 180 mg loading dose without morphine
Design
Cohort
Authors
Discussion
Loading...
Member takes
Implication
Morphine use in STEMI may reflect sicker patients with differing characteristics; leaves open whether it independently impairs ticagrelor-mediated reperfusion.
Structured PICO
Does morphine use affect pre-PCI ST-segment elevation resolution and clinical outcomes in STEMI patients receiving ticagrelor?
P
Population
1,862 STEMI patients in the acute ambulance/hospital setting undergoing primary percutaneous coronary intervention (from the ATLANTIC study)
I
Intervention
Morphine (or other opioids) in addition to ticagrelor 180 mg loading dose
C
Comparator
Ticagrelor 180 mg loading dose without morphine
O
Outcome
Pre-PCI ≥ 70% ST-segment elevation resolutionsurrogate
In STEMI patients receiving ticagrelor, morphine use is associated with reduced pre-PCI coronary flow and increased bleeding without improving ST-segment resolution, supporting the judicious use of opioids.
Cite This Study
Lapostolle et al. (2018) studied this question.