The effect of morphine and pethidine on mortality of patients undergoing primary PCI

Abstract

The use of analgesic drugs in the acute phase of myocardial infarction with ST-segment elevation is one of the routine treatments to reduce pain in these patients. Numerous studies have been reported on the possible effect of morphine on the clinical outcome of patients undergoing mechanical reperfusion with PPCI following STEMI, and conflicting results have been obtained. Due to the limitations of similar studies in Iran in terms of comparing pethidine and morphine in this study, we decided to compare the effects of morphine and pethidine on infarction, enzyme and hospital mortality and one-year mortality of STEMI patients undergoing primary angioplasty. Materials and Methods: In this retrospective study, 172 patients who underwent primary angioplasty with a diagnosis of acute myocardial infarction with elevated ST segment between 2018 and 2019 were included in the study. Demographic, clinical, laboratory angiographic information of these patients were summarized and the above characteristics as well as hospital and one-year complications were compared. Results: 85.6% of patients were male and the mean age was 60.21±10.16 years. Most patients who received morphine had AntMI. Door To Balloon time was longer in the morphine + pethidine group than the other two groups (159/85±139/59, P value<0/001).The rate of ST reduction was more than 50% after primary angioplasty in the pethidine group was more than other groups (82.7% VS 54.9%, P-Value = 0.002) Peak troponin levels in the morphine group were significantly higher than the other groups. (29.7 ± 12.5 VS 19.16 ± 8.74, P-Value = 0.017). There was no significant difference between the two groups in terms of hospital and long-term mortality.