The Effect of Morphine on Prasugrel Absorption in STEMI Patients

Sheffield Teaching Hospitals NHS Foundation Trust12 enrolled

Overview

Heart Attacks are a major cause of death in this country. When patients have a heart attack, they are treated with anti-clotting drugs, one of which is a drug called Prasugrel. It is important that Prasugrel starts to work as quickly as possible following a heart attack. As many patients who have a heart attack experience excruciating pain, they are often given morphine (a strong painkiller) by the Ambulance crew. We think that morphine may affect how Prasugrel is absorbed from the stomach and may delay how quickly it starts to work. We intend to study the effect of morphine on the absorption of Prasugrel.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

OTHER

Masking

NONE

Enrollment

Conditions

Cardiovascular Disease

Interventions

Eligibility

Sex: ALLMin age: 18 YearsMax age: 75 Years

Medical Language ↔ Plain English

Inclusion Criteria: * \>18 years of age and willing and able to provide informed consent * Admission to hospital with a STEMI \>12 months prior to recruitment * Previous prasugrel and morphine use with no adverse effect Exclusion Criteria: * Active respiratory disorder, resting oxygen saturation \< 95% or decompensated congestive cardiac failure * Current use of anti-platelet or anti-coagulant drugs apart from aspirin 75 mg daily, or receipt of any dose of clopidogrel, prasugrel or ticagrelor in the last 2 weeks * Current use of opiate analgesia

Outcomes

Primary Outcomes

VerifyNow P2Y12 PRU measurement at 2 hours post dose

Assessment of platelet function

Time frame: 2 hours

Secondary Outcomes

Estimated time to PRU less than 150; maximal LTA response to ADP 20 microM at 2 hours post dose; final LTA response to ADP 5 microM at 2 hours post dose.

further assessment of platelet function