Universidad Peruana Cayetano Heredia

Morphine and clinical outcomes in patients with ST segment elevation myocardial infarction treated with fibrinolytic and antiplatelet therapy: Insights from the TREAT trial

Mostrar el registro sencillo del ítem

dc.contributor.author Cantor, Warren J.
dc.contributor.author Tan, Mary
dc.contributor.author Berwanger, Otavio
dc.contributor.author Lavi, Shahar
dc.contributor.author White, Harvey D.
dc.contributor.author Nicolau, Jose C.
dc.contributor.author Dehghani, Payam
dc.contributor.author Tajer, Carlos D.
dc.contributor.author Lopes, Renato D.
dc.contributor.author Moia, Diogo D. F.
dc.contributor.author Nicholls, Stephen J.
dc.contributor.author Parkhomenko, Alexander
dc.contributor.author Averkov, Oleg
dc.contributor.author Brass, Neil
dc.contributor.author Lutchmedial, Sohrab
dc.contributor.author Málaga Rodríguez, Germán Javier
dc.contributor.author Damiani, Lucas P.
dc.contributor.author Piegas, Leopoldo S.
dc.contributor.author Granger, Christopher B.
dc.contributor.author Goodman, Shaun G.
dc.date.accessioned 2022-11-15T23:04:38Z
dc.date.available 2022-11-15T23:04:38Z
dc.date.issued 2022
dc.identifier.uri https://hdl.handle.net/20.500.12866/12555
dc.description.abstract Background: Morphine is commonly used to relieve pain, anxiety and dyspnea in STEMI but it lowers blood pressure and delays the activity of oral antiplatelet agents. The impact of morphine on clinical outcomes remains unknown. This analysis was performed to determine if morphine use was associated with increased risk of adverse clinical events among STEMI patients treated with fibrinolytic therapy and clopidogrel or ticagrelor. Methods: In the Ticagrelor in Patients with ST Elevation Myocardial Infarction Treated with Pharmacological Thrombolysis (TREAT) study, 3799 STEMI patients treated with fibrinolysis were randomized to receive clopidogrel or ticagrelor. Morphine use was left to the discretion of the treating physicians. In this pre-specified analysis, we evaluated clinical outcomes based on the use and timing of morphine administration. Outcomes were stratified by randomized treatment group. Multivariable analysis was performed using Inverse Probability Treatment Weighting (IPTW) weighting. Results: Morphine was used in 53% of patients. After adjustment using IPTW weighting, morphine use was associated with higher hazard of reinfarction at 7 days (HR 4.9, P = .0006) and 30 days (HR 1.7, P = .04), and lower hazard of major bleeding (HR 0.37, P = .006). There was no significant difference in mortality at any time point. Conclusions: Among patients with STEMI treated with fibrinolytic therapy, morphine use was associated with a higher risk of early reinfarction and a lower risk of major bleeding but no difference in mortality. en_US
dc.language.iso eng
dc.publisher Elsevier
dc.relation.ispartofseries American Heart Journal
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject Morphine en_US
dc.subject clinical outcomes en_US
dc.subject patients en_US
dc.subject ST segment en_US
dc.subject myocardial infarction en_US
dc.subject fibrinolytic en_US
dc.subject antiplatelet therapy en_US
dc.title Morphine and clinical outcomes in patients with ST segment elevation myocardial infarction treated with fibrinolytic and antiplatelet therapy: Insights from the TREAT trial en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1016/j.ahj.2022.05.005
dc.relation.issn 1097-6744


Ficheros en el ítem

Ficheros Tamaño Formato Ver

No hay ficheros asociados a este ítem.

Este ítem aparece en la(s) siguiente(s) colección(ones)

Mostrar el registro sencillo del ítem

info:eu-repo/semantics/restrictedAccess Excepto si se señala otra cosa, la licencia del ítem se describe como info:eu-repo/semantics/restrictedAccess

Buscar en el Repositorio


Listar

Panel de Control

Estadísticas