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The current prospective, randomized, controlled MonAMI trial aims to systematically examine the effects of morphine on the platelet inhibitory effects of the orally administered platelet inhibitor ticagrelor in patients with acute myocardial infarction. In addition, the potential positive or negative effects of MCP in combination with morphine on platelet inhibition will be studied.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Isotonic sodium chloride + Ticagrelor | Active Comparator | 46 patients with NaCl i.v. and 180 mg ticagrelor orally pre revascularization plus medical standard therapy |
|
| Morphinhydrochloricum + Ticagrelor | Experimental | 46 patients with 5 mg morphine i.v. and 180 mg ticagrelor pre revascularization plus medical standard therapy |
|
| Morphinhydrochloricum + Ticagrelor + Metoclopramide | Experimental | 46 patients with 5 mg morphine i.v. and 10 mg MCP i.v. and 180 mg ticagrelor pre revascularization plus medical standard therapy |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Morphinhydrochloricum | Drug | 5 mg morphine intravenously |
|
| Measure | Description | Time Frame |
|---|---|---|
| Platelet activity 2 hours after administration of loading dose of ticagrelor measured by VerifyNow-P2Y12-test | 2 hours |
| Measure | Description | Time Frame |
|---|---|---|
| Platelet reactivity 0.5, 1, 4, 6 and 24 hours after loading dose of ticagrelor measured by VerifyNow-P2Y12-test | 0.5, 1, 4, 6 h and 24 hours | |
| Platelet reactivity 0.5, 1, 2, 4, 6 and 24 hours after loading dose of ticagrelor measured by Vasodilator Stimulated Phosphoprotein-test |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University of Luebeck | Lübeck | 23538 | Germany |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 33899498 | Derived | Stiermaier T, Schaefer P, Meyer-Saraei R, Saad M, de Waha-Thiele S, Poss J, Fuernau G, Graf T, Kurz T, Frydrychowicz A, Barkhausen J, Desch S, Thiele H, Eitel I. Impact of Morphine Treatment With and Without Metoclopramide Coadministration on Myocardial and Microvascular Injury in Acute Myocardial Infarction: Insights From the Randomized MonAMI Trial. J Am Heart Assoc. 2021 May 4;10(9):e018881. doi: 10.1161/JAHA.120.018881. Epub 2021 Apr 26. | |
| 32310699 |
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| ID | Term |
|---|---|
| D008787 | Metoclopramide |
| D000077486 | Ticagrelor |
| D012965 | Sodium Chloride |
| ID | Term |
|---|---|
| D001549 | Benzamides |
| D000577 | Amides |
| D009930 | Organic Chemicals |
| D062366 | para-Aminobenzoates |
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| Metoclopramide | Drug | 10 mg MCP intravenously |
|
|
| Ticagrelor | Drug | 180 mg ticagrelor orally |
|
|
| Isotonic sodium chloride | Drug | 10 ml NaCl 0.9% intravenously |
|
|
| 0.5, 1, 2, 4, 6 h and 24 hours |
| Percentage of patients with high on-treatment platelet reactivity 0.5, 1, 2, 4, 6 and 24 hours after loading dose of ticagrelor (measured by VerifyNow-P2Y12-test) | 0.5, 1, 2, 4, 6 h and 24 hours |
| Ticagrelor plasma levels and levels of active serum metabolites after 0.5, 1, 2, 4, 6 and 24 hours | 0.5, 1, 2, 4, 6 h and 24 hours |
| Infarct size measured by delayed enhancement magnetic resonance imaging | Day 1-4 |
| Microvascular obstruction measured by delayed enhancement magnetic resonance imaging | Cardiac magnetic resonance imaging equivalent of angiographic no-reflow, expressed as percentage of left ventricular mass | Day 1-4 |
| Derived |
| Saad M, Meyer-Saraei R, de Waha-Thiele S, Stiermaier T, Graf T, Fuernau G, Langer HF, Kurz T, Poss J, Barkhausen J, Desch S, Eitel I, Thiele H. Impact of Morphine Treatment With and Without Metoclopramide Coadministration on Ticagrelor-Induced Platelet Inhibition in Acute Myocardial Infarction: The Randomized MonAMI Trial. Circulation. 2020 Apr 21;141(16):1354-1356. doi: 10.1161/CIRCULATIONAHA.119.042816. Epub 2020 Apr 20. No abstract available. |
| D062365 |
| Aminobenzoates |
| D001565 | Benzoates |
| D000146 | Acids, Carbocyclic |
| D002264 | Carboxylic Acids |
| D002723 | Chlorobenzoates |
| D062425 | Hydroxybenzoate Ethers |
| D062385 | Hydroxybenzoates |
| D006880 | Hydroxy Acids |
| D001555 | Benzene Derivatives |
| D006841 | Hydrocarbons, Aromatic |
| D006844 | Hydrocarbons, Cyclic |
| D006838 | Hydrocarbons |
| D010647 | Phenyl Ethers |
| D010636 | Phenols |
| D000241 | Adenosine |
| D011684 | Purine Nucleosides |
| D011687 | Purines |
| D006574 | Heterocyclic Compounds, 2-Ring |
| D000072471 | Heterocyclic Compounds, Fused-Ring |
| D006571 | Heterocyclic Compounds |
| D009705 | Nucleosides |
| D009706 | Nucleic Acids, Nucleotides, and Nucleosides |
| D012263 | Ribonucleosides |
| D002712 | Chlorides |
| D006851 | Hydrochloric Acid |
| D017606 | Chlorine Compounds |
| D007287 | Inorganic Chemicals |
| D017670 | Sodium Compounds |