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Robert E. Lee's Last Stand: His Dying Words and the Stroke That Killed Him. (P1.294)
CONCLUSIONS: Lee suffered chronic angina and congestive heart failure, with a probable myocardial infarction during the war. His death stemmed from an acute, possibly cardioembolic stroke manifesting as expressive aphasia, and subsequent respiratory complications. Given his aphasia, Lee’s famous last words are questionable.Disclosure: Dr. Southerland has received personal compensation in an editorial capacity for Neurology Podcast.
Source: Neurology - April 9, 2014 Category: Neurology Authors: Southerland, A. Tags: History of Neurology Source Type: research

The safety of morphine use in acute coronary syndrome: a meta-analysis
Conclusion The use of morphine for pain control in ACS was associated with an increased risk of in-hospital recurrent MI. Randomised clinical trials are needed to further investigate the safety of morphine in ACS.
Source: Heart Asia - March 19, 2019 Category: Cardiology Authors: Ghadban, R., Enezate, T., Payne, J., Allaham, H., Halawa, A., Fong, H. K., Abdullah, O., Aggarwal, K. Tags: Open access Original research Source Type: research

Multimodal analgesia versus traditional opiate based analgesia after cardiac surgery, a randomized controlled trial
Background: To evaluate if an opiate sparing multimodal regimen of dexamethasone, gabapentin, ibuprofen and paracetamol had better analgesic effect, less side effects and was safe compared to a traditional morphine and paracetamol regimen after cardiac surgery. Methods: Open-label, prospective randomized controlled trial. 180 patients undergoing cardiac procedures through median sternotomy, were included in the period march 2007- August 2009. 151 patients were available for analysis. Pain was assessed with the 11-numeric rating scale (11-NRS). Results: Patients in the multimodal group demonstrated significantly lower avera...
Source: Journal of Cardiothoracic Surgery - March 20, 2014 Category: Cardiovascular & Thoracic Surgery Authors: Sulman RafiqDaniel SteinbrüchelMichael WanscherLars AndersenAlbert NavneNikolaj LilleoerPeter Olsen Source Type: research

0209: Long-term clinical impact of pre-hospital morphine use in ST-elevation myocardial infarction patients. FAST-MI 2010 registry
Conclusion Pre-hospital morphine use was not associated with an increase of in-hospital complication and one-year mortality; and, could be more used as recommended in the current guidelines.
Source: Archives of Cardiovascular Diseases Supplements - February 12, 2015 Category: Cardiology Source Type: research

Correlates of pre-hospital morphine use in ST-elevation myocardial infarction patients and its association with in-hospital outcomes and long-term mortality: the FAST-MI (French Registry of Acute ST-elevation and non-ST-elevation Myocardial Infarction) programme
Conclusion In two independent everyday-life cohorts, pre-hospital morphine use in STEMI patients was not associated with worse in-hospital complications and 1-year mortality. Clinical trial registration Clinicaltrials.gov identifier: NCT00673036 (FAST-MI 2005); NCT01237418 (FAST-MI 2010).
Source: European Heart Journal - March 31, 2016 Category: Cardiology Authors: Puymirat, E., Lamhaut, L., Bonnet, N., Aissaoui, N., Henry, P., Cayla, G., Cattan, S., Steg, G., Mock, L., Ducrocq, G., Goldstein, P., Schiele, F., Bonnefoy-Cudraz, E., Simon, T., Danchin, N. Tags: Acute coronary syndromes Source Type: research

The Risk of Ischemic Cardio- and Cerebrovascular Events Associated with Oxycodone –Naloxone and Other Extended-Release High-Potency Opioids: A Nested Case–Control Study
ConclusionsOur study does not indicate an association between oxycodone –naloxone and ischemic cardio- or cerebrovascular events. However, our findings do suggest that every change in ER HPO therapy should be conducted with caution.
Source: Drug Safety - February 12, 2017 Category: Drugs & Pharmacology Source Type: research

Morphine and Ticagrelor Interaction in Primary Percutaneous Coronary Intervention in ST-Segment Elevation Myocardial Infarction: ATLANTIC-Morphine
ConclusionsMorphine-treatment was associated with increased GP IIb/IIIa inhibitor use, less pre-PCI TIMI 3 flow, and more bleeding. Judicious morphine use is advised with non-opioid analgesics preferred for non-severe acute pain.Trial Registrationclinicaltrials.gov identifier: NCT01347580.
Source: American Journal of Cardiovascular Drugs - October 23, 2018 Category: Cardiology Source Type: research

Effect of morphine use on oral P2Y12 platelet inhibitors in acute myocardial infarction: Meta-analysis
ConclusionCo-administration of morphine with P2Y12 inhibitors possibly decreases their efficacy in platelet inhibition. However, this did not translate into higher adverse outcomes due to low event rates, inadequate for analysis. A large randomized study is needed to evaluate the narcotic-P2Y12 interaction.
Source: Indian Heart Journal - March 20, 2019 Category: Cardiology Source Type: research

Effect of morphine use on oral P2Y12 platelet inhibitors in acute myocardial infarction: Meta-analysis.
CONCLUSION: Co-administration of morphine with P2Y12 inhibitors possibly decreases their efficacy in platelet inhibition. However, this did not translate into higher adverse outcomes because of low event rates, inadequate for analysis. A large randomized study is needed to evaluate the narcotic-P2Y12 interaction. PMID: 31280824 [PubMed - in process]
Source: Indian Heart J - February 28, 2019 Category: Cardiology Authors: Vaidya GN, Khan A, Ghafghazi S Tags: Indian Heart J Source Type: research

FMD and SCAD: Sex-Biased Arterial Diseases With Clinical and Genetic Pleiotropy
Circ Res. 2021 Jun 11;128(12):1958-1972. doi: 10.1161/CIRCRESAHA.121.318300. Epub 2021 Jun 10.ABSTRACTMultifocal fibromuscular dysplasia (FMD) and spontaneous coronary artery dissection are both sex-biased diseases disproportionately affecting women over men in a 9:1 ratio. Traditionally known in the context of renovascular hypertension, recent advances in knowledge about FMD have demonstrated that FMD is a systemic arteriopathy presenting as arterial stenosis, aneurysm, and dissection in virtually any arterial bed. FMD is also characterized by major cardiovascular presentations including hypertension, stroke, and myocardi...
Source: Circulation Research - June 10, 2021 Category: Cardiology Authors: Esther S H Kim Jacqueline Saw Daniella Kadian-Dodov Malissa Wood Santhi K Ganesh Source Type: research