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Research article
yaowang lin
Shenzhen People's Hospital
Corresponding Author
ORCiD: https://orcid.org/0000-0002-4075-4259
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: The available data regarding the safety of morphine use in cases of STEMI with AHF (Killip ≥2) remain insufficient. The aim of the study was to further examine the safety of intravenous morphine in patients with STEMI and AHF over 1 year of follow-up after primary percutaneous coronary intervention (PPCI).
Methods: 275 consecutive patients with STEMI and AHF were included and divided into groups that did or did not receive in-hospital intravenous morphine. Endpoints included major adverse cardiovascular events (MACEs) and the need for invasive mechanical ventilation during hospitalization and 1 year of follow-up.
Results: The in-hospital occurrences of cardiac death and cardiogenic shock were much higher in patients who received morphine than that those who did not (15.20% vs 6.67%, p=0.035; odds ratio [OR]=2.509, 95% confidence interval [CI] 1.121–5.620, and 14.40% vs 6.00%, p=0.033; OR=2.636, 95% CI 1.139-6.097, respectively). Additionally, more patients in the group treated with morphine experienced the secondary outcome of in-hospital invasive mechanical ventilation compared with the group not treated with morphine (19.20% vs 10.67%, p=0.031; OR=2.308, 95% CI 1.138–4.684). However, no difference between-group differences were observed for the incidence of MACEs, cardiac death, or all-cause death over 1 year of follow-up.
Conclusions: Intravenous morphine administration is highly correlated with in-hospital MACEs and the need for additional invasive mechanical ventilation in STEMI patients with AHF after PPCI, but not for long-time adverse outcomes.
Keywords
morphine, ST-segment elevation myocardial infarction, PPCI, acute heart failure, invasive mechanical ventilation
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On 21 Oct, 2020
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Received 16 Oct, 2020
Reviewer #3 agreed
On 06 Oct, 2020
Reviewer #2 agreed
On 03 Oct, 2020
Reviewer #1 agreed
On 20 Sep, 2020
Review #1 received
Received 20 Sep, 2020
Reviewers invited
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A new preprint design is coming!
We have improved readability, clarity, accessibility, and opportunities for engagement.
This preprint is under consideration at BMC Cardiovascular Disorders. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
yaowang lin
Shenzhen People's Hospital
Corresponding Author
ORCiD: https://orcid.org/0000-0002-4075-4259
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Review
Version 1
Posted 15 Sep, 2020
No community comments so far
Editorial decision: Major revision
On 21 Oct, 2020
Review #3 received
Received 20 Oct, 2020
Review #2 received
Received 16 Oct, 2020
Reviewer #3 agreed
On 06 Oct, 2020
Reviewer #2 agreed
On 03 Oct, 2020
Reviewer #1 agreed
On 20 Sep, 2020
Review #1 received
Received 20 Sep, 2020
Reviewers invited
Invitations sent on 11 Sep, 2020
First submitted
On 03 Sep, 2020
Editor assigned
On 03 Sep, 2020
Submission checks complete
On 02 Sep, 2020
Editor invited
On 02 Sep, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: The available data regarding the safety of morphine use in cases of STEMI with AHF (Killip ≥2) remain insufficient. The aim of the study was to further examine the safety of intravenous morphine in patients with STEMI and AHF over 1 year of follow-up after primary percutaneous coronary intervention (PPCI).
Methods: 275 consecutive patients with STEMI and AHF were included and divided into groups that did or did not receive in-hospital intravenous morphine. Endpoints included major adverse cardiovascular events (MACEs) and the need for invasive mechanical ventilation during hospitalization and 1 year of follow-up.
Results: The in-hospital occurrences of cardiac death and cardiogenic shock were much higher in patients who received morphine than that those who did not (15.20% vs 6.67%, p=0.035; odds ratio [OR]=2.509, 95% confidence interval [CI] 1.121–5.620, and 14.40% vs 6.00%, p=0.033; OR=2.636, 95% CI 1.139-6.097, respectively). Additionally, more patients in the group treated with morphine experienced the secondary outcome of in-hospital invasive mechanical ventilation compared with the group not treated with morphine (19.20% vs 10.67%, p=0.031; OR=2.308, 95% CI 1.138–4.684). However, no difference between-group differences were observed for the incidence of MACEs, cardiac death, or all-cause death over 1 year of follow-up.
Conclusions: Intravenous morphine administration is highly correlated with in-hospital MACEs and the need for additional invasive mechanical ventilation in STEMI patients with AHF after PPCI, but not for long-time adverse outcomes.
Figure 1
Figure 2
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