Evidence map›Paper›PMID 30340532›Full record

Trial reportBMC cardiovascular disorders2018

Intra-coronary morphine versus placebo in the treatment of acute ST-segment elevation myocardial infarction: the MIAMI randomized controlled trial.

Philippe Le Corvoisier, Romain Gallet, Pierre-François Lesault, Etienne Audureau, Muriel Paul, Julien Ternacle, Saïd Ghostine, Stéphane Champagne, Raphaele Arrouasse, Dalila Bitari and 6 more

Registry-linked trialOpen access · goldAbstract readMulticenter StudyRandomized Controlled Trial
In one paragraph

Trial report in BMC cardiovascular disorders, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01186445 (Evaluation of the Cardioprotective Effect of Intracoronary Injection of Morphine During Reperfusion in Acute Myocardial Infarction), which is not on this map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
1.0field-weighted citation impact, top 24% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT01186445 phase3completednot on this map

Evaluation of the Cardioprotective Effect of Intracoronary Injection of Morphine During Reperfusion in Acute Myocardial Infarction

TypeinterventionalSponsorFrench Cardiology SocietyRan2011 to 2016Enrolled94ConditionsAcute Myocardial InfarctionArmsmorphine chlorhydrate, saline solution
3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 12 citations in OpenAlex.

  1. Article
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors at 4 institutions in 1 country.

Philippe Le CorvoisierDepartment VERDI, Inserm, CIC1430, AP-HP, Henri Mondor Hospital, 51 Avenue du Maréchal de Lattre de Tassigny, F-94010, Creteil, France. philippe.lecorvoisier@aphp.fr.ORCID 0000-0003-0402-9591
Romain GalletInserm, U955 team 3, F-94010, Creteil, France.
Pierre-François LesaultInterventional Cardiology Unit, AP-HP, Henri Mondor Hospital, F-94010, Creteil, France.
Etienne AudureauDepartment of Public Health and CEPIA EA7376, AP-HP, Henri Mondor Hospital, F-94010, Creteil, France.
Muriel PaulDepartment of Pharmacy, AP-HP, Henri Mondor Hospital, F-94010, Creteil, France.
Julien TernacleInterventional Cardiology Unit, AP-HP, Henri Mondor Hospital, F-94010, Creteil, France.
Saïd GhostineDepartment of Cardiology, Marie-Lannelongue Hospital, F-92350, Le Plessis-Robinson, France.
Stéphane ChampagneInterventional Cardiology Unit, AP-HP, Henri Mondor Hospital, F-94010, Creteil, France.
Raphaele ArrouasseDepartment VERDI, Inserm, CIC1430, AP-HP, Henri Mondor Hospital, 51 Avenue du Maréchal de Lattre de Tassigny, F-94010, Creteil, France.
Dalila BitariDepartment VERDI, Inserm, CIC1430, AP-HP, Henri Mondor Hospital, 51 Avenue du Maréchal de Lattre de Tassigny, F-94010, Creteil, France.
Gauthier MouilletInterventional Cardiology Unit, AP-HP, Henri Mondor Hospital, F-94010, Creteil, France.
Jean-Luc Dubois-RandéInserm, U955 team 3, F-94010, Creteil, France.
Alain BerdeauxInserm, U955 team 3, F-94010, Creteil, France.
Bijan GhalehInserm, U955 team 3, F-94010, Creteil, France.
Jean-François DeuxDepartment of Radiology, AP-HP, Henri Mondor Hospital, F-94010, Creteil, France.
Emmanuel TeigerInserm, U955 team 3, F-94010, Creteil, France.
Inserm · FRUniversité Paris-Est Créteil · FRAssistance Publique – Hôpitaux de Paris · FRHôpital Marie Lannelongue · FR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundExperimental studies suggest that morphine may protect the myocardium against ischemia-reperfusion injury by activating salvage kinase pathways. The objective of this two-center, randomized, double-blind, controlled trial was to assess potential cardioprotective effects of intra-coronary morphine in patients with ST-segment elevation myocardial infarction (STEMI) referred for primary percutaneous intervention.

methodsNinety-one patients with STEMI were randomly assigned to intracoronary morphine (1 mg) or placebo at reperfusion of the culprit coronary artery. The primary endpoint was infarct size/left ventricular mass ratio assessed by magnetic resonance imaging on day 3-5. Secondary endpoints included the areas under the curve (AUC) for troponin T and creatine kinase over three days, left ventricular ejection fraction assessed by echocardiography on days 1 and 6, and clinical outcomes.

resultsInfarct size/left ventricular mass ratio was not significantly reduced by intracoronary morphine compared to placebo (27.2% ± 15.0% vs. 30.5% ± 10.6%, respectively, p = 0.28). Troponin T and creatine kinase AUCs were similar in the two groups. Morphine did not improve left ventricular ejection fraction on day 1 (49.7 ± 10.3% vs. 49.3 ± 9.3% with placebo, p = 0.84) or day 6 (48.5 ± 10.2% vs. 49.0 ± 8.5% with placebo, p = 0.86). The number of major adverse cardiac events, including stent thrombosis, during the one-year follow-up was similar in the two groups.

conclusionsIntracoronary morphine at reperfusion did not significantly reduce infarct size or improve left ventricular systolic function in patients with STEMI. Presence of comorbidities in some patients may contribute to explain these results.

trial registrationClinicalTrials.gov, NCT01186445 (date of registration: August 23, 2010).

Indexed as

Percutaneous Coronary InterventionAgedDouble-Blind MethodFemaleFranceHumansInjections, Intra-ArterialMagnetic Resonance ImagingMaleMiddle AgedMorphineMyocardial Reperfusion InjuryMyocardiumProtective AgentsRecovery of FunctionST Elevation Myocardial InfarctionMorphineProtective AgentsCardioprotectionInfarct sizeMorphineReperfusion injurySTEMI

Identifiers

PMID30340532
PMCPMC6194573
OpenAlexW2896703493

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.