Using morphine to reduce chest pain in heart attack patients may increase their risk of death by nearly 50%, according to Duke University researchers.

The Study

Researchers analyzed the clinical data and outcomes of more than 57,000 high-risk heart attack patients. Of those, 30% received morphine within the first 24 hours after they were admitted to a hospital.

The study found that the death rate for patients who received morphine was nearly twice as high as for patients who initially received nitroglycerine for their chest pain.

"Since randomized clinical trials evaluating the safety or effectiveness of morphine for these patients have not been conducted, official guidelines for its use are based solely on expert conjecture," says Duke cardiologist Dr. Trip Meine. "The results of this analysis raise serious concerns about the safety of the routine use of morphine in this group of heart patients...A randomized clinical trial is in order," he says.

Until such a trial is conducted, Meine and his colleagues recommend that cardiologists first use sufficient doses of nitroglycerine to relieve pain in heart attack patients before resorting to morphine.

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