Key result
Intravenous morphine significantly delayed the time to adequate platelet inhibition after prasugrel administration compared to saline (158 vs 68 min; p = 0.006).
Why the study?
Does intravenous morphine delay the onset of action of prasugrel in aspirin-treated patients with a prior history of STEMI?
Population
11 aspirin-treated patients with prior history of ST-elevation myocardial infarction treated with primary…
Comparison
Morphine intravenously followed by 60 mg prasugrel vs Saline intravenously followed by 60 mg prasugrel
Design
RCT, Randomised to receive either morphine or saline intravenously in a…
Follow-up
24 hours
Authors
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Morphine may delay prasugrel onset in prior-STEMI patients; leaves open need for bridging strategies in PPCI.
RCT (n=11)
crossover
Does intravenous morphine delay the onset of action of prasugrel in aspirin-treated patients with a prior history of STEMI?
Absolute Event Rate: 158% vs 68%
p-value: p=0.006
Prior administration of intravenous morphine significantly delays the onset of action of prasugrel, suggesting that intravenous antiplatelet drugs may be necessary to reduce the risk of acute stent thrombosis in morphine-treated STEMI patients undergoing PPCI.
Thomas et al. (2016) conducted an RCT in prior history of ST-elevation myocardial infarction (STEMI) (n=11). Morphine vs. Saline intravenously followed by 60 mg prasugrel was evaluated on Time to adequate platelet inhibition (p=0.006). Intravenous morphine significantly delayed the time to adequate platelet inhibition after prasugrel administration compared to saline (158 vs 68 min; p = 0.006).
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