Effects of Morphine on Loading-dose Ticagrelor in Patients With ST-segment Elevation Myocardial Infarction

• Status: Recruiting
• Trial end date: 2020-08-15
• Target enrollment: 0
• Participant gender: All

Summary

Percutaneous coronary intervention(PCI) has become the first choice for STEMI patients.According to the current guidelines,dual antiplatelet therapy with a P2Y12 receptor inhibitor and aspirin ,and intravenous injection of morphine therapy for chest pain relief in necessity play a pivotal role in the treatment of patients with ST elevation myocardial infarction before primary percutaneous coronary intervention.And ticagrelor is recommended in patients with ST segment elevation myocardial infarction undergoing PCI, with class IB indication.Therefore coadministration of morphine and ticagrelor are commonplace.Currently, some studies have found that morphine delayed and attenuated exposure to ticagrelor,but it is not clear of the pathogenesis of it.Some researchers say that morphine results in a weaker and retarded antiplatelet effect of ticagrelor in STEMI patients before PCI by inhibition of gastrointestinal peristalsis and causing vomiting.The study is aimed at exploring whether morphine delay and attenuate exposure to ticagrelor and its antiplatelet effect.In addition, the trial will explore the possible mechanism which morphne delay and attenuate exposure to ticagrelor in patients with ST-segment elevation myocardial infarction before PCI.

• Phase: Phase 4
• Accepts Healthy Volunteers?: No

Details

• Lead Sponsor: General Hospital of Chinese Armed Police Forces
• Treatments: Metoclopramide; Morphine; Ticagrelor

Criteria

Inclusion Criteria:

1. Provision of informed consent prior to any study-specific procedures

2. Male or female aged from 18 to 80 years old

3. Patients with STEMI scheduled to undergo PCI.

Exclusion Criteria:

1. Hypersensitivity to the active substance or to any of the excipients

2. Active bleeding or bleeding diathesis

3. Previous transient ischemic attack

4. Antiplatelet (clopidogrel, prasugrel, ticagrelor) administration in the week before the index event

5. Known relevant hematological conditions

6. Left ventricular ejection fraction ≤ 30%

7. Renal failure with creatinine ≥ 3 mg/dl

8. History of liver disease

9. Increased risk of bradycardia

10. Concomitant therapy with drugs known to interfere with CYP3A4 metabolism.