The impact of using morphine or meperidine on clinical outcomes of ST-elevation myocardial infarction patients undergoing primary percutaneous intervention

Farzaneh  Hashemzadeh; Amirhosein  Ghafouri-Asbagh; Amirreza  Khalaji; Negar  Jafari; Ahmad  Separham

doi:10.18502/cbj.v5i2.21136

Farzaneh Hashemzadeh Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
Amirhosein Ghafouri-Asbagh Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
Amirreza Khalaji Immunology Research Center, Tabriz University of medical sciences, Tabriz, Iran
Negar Jafari Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
Ahmad Separham Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran

DOI: https://doi.org/10.18502/cbj.v5i2.21136

Keywords: ST-elevation MI, Percutaneous intervention, Morphine, Meperidine

Abstract

Objectives: Opioids are commonly used for treating chest pain in patients with acute coronary syndrome. Despite the beneficial effects of opioids, they could have adverse effects on patients, too. This study aims to compare the effects of morphine and meperidine on major adverse cardiac events (MACE) and mortality in patients undergoing percutaneous intervention.

Methods: The researchers retrospectively reviewed data from 161 patients with the confirmed diagnosis of ST-elevation myocardial infarction undergoing primary percutaneous intervention. We compared the medical records of patients with MACE. In-hospital and one-year MACE were our primary measured outcomes.

Results: Patients treated with morphine were more likely to experience in-hospital MACE (P-value: 0.006). Heart failure in the hospital was more in the morphine group (p-value: 0.002). However, none of the one-year clinical outcomes were statistically different between the two groups treated with morphine or meperidine. Left ventricular ejection fraction, ischemic heart disease, and hospital length of stay remained independent variables for predicting both in-hospital and one-year MACE, but morphine or meperidine didn’t remain independent in multivariable analysis.

Conclusions: Although heart failure occurred more frequently in patients who received morphine, neither morphine nor meperidine independently predicted in-hospital or one-year MACE.