{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T11:59:44Z","timestamp":1790769584211,"version":"4.1.0"},"reference-count":29,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2019,1,22]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Morphine administration is a strong predictor of delayed onset of action of orally administered ticagrelor in patients with ST\u2010segment\u2013elevation myocardial infarction, likely because of impaired gastrointestinal motility. The aim of this study was to evaluate whether the peripheral opioid antagonist methylnaltrexone could improve pharmacodynamics and pharmacokinetics of orally administered ticagrelor in patients with ST\u2010segment\u2013elevation myocardial infarction receiving morphine.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              The MOVEMENT (Methylnaltrexone to Improve Platelet Inhibition of Ticagrelor in Morphine\u2010Treated Patients With ST\u2010Segment Elevation Myocardial Infarction) trial was a multicenter, prospective, randomized, controlled trial in patients with ST\u2010segment\u2013elevation myocardial infarction treated with morphine and ticagrelor. Upon arrival to the catheterization laboratory, patients were randomized to a blinded intravenous injection of either methylnaltrexone (8 or 12\u00a0mg according to weight) or 0.9% sodium chloride. The proportion of patients with high on\u2010treatment platelet reactivity and plasma concentrations of ticagrelor and\n              <jats:styled-content style=\"fixed-case\">AR<\/jats:styled-content>\n              \u2010C124910XX were assessed at baseline (arrival in the catheterization laboratory) and 1 and 2\u00a0hours later. A total of 82 patients received either methylnaltrexone (n=43) or placebo (n=39). Median (interquartile range) time from ticagrelor administration to randomization was 41 (31\u201350) versus 45.5 (37\u201360) minutes (\n              <jats:italic>P<\/jats:italic>\n              =0.16). Intravenous methylnaltrexone administration did not significantly affect prevalence of high on\u2010treatment platelet reactivity at 2\u00a0hours after inclusion, the primary end point, when compared with placebo (54% versus 51%,\n              <jats:italic>P<\/jats:italic>\n              =0.84). Plasma concentrations of ticagrelor and its active metabolite, the prespecified secondary end points, did not differ significantly between the groups over time. There was no significant difference in patient self\u2010estimated pain between the groups.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Methylnaltrexone did not significantly improve platelet reactivity or plasma concentrations of orally administered ticagrelor in patients with ST\u2010segment\u2013elevation myocardial infarction receiving morphine.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Clinical Trial Registration<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              <jats:styled-content style=\"fixed-case\">URL<\/jats:styled-content>\n              :\n              <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/www.clinicaltrials.gov\">http:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n              . Unique identifier:\n              <jats:styled-content style=\"fixed-case\">NCT<\/jats:styled-content>\n              02942550.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.118.010152","type":"journal-article","created":{"date-parts":[[2019,1,13]],"date-time":"2019-01-13T10:00:28Z","timestamp":1547373628000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":22,"title":["The MOVEMENT Trial"],"prefix":"10.1161","volume":"8","author":[{"given":"Manne","family":"Holm","sequence":"first","affiliation":[{"name":"Department of Molecular Medicine and Surgery Karolinska Institutet Stockholm Sweden"},{"name":"Perioperative Medicine and Intensive Care, B31 Karolinska University Hospital Huddinge, Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Per","family":"Tornvall","sequence":"additional","affiliation":[{"name":"Unit of Cardiology Department of Clinical Science and Education S\u00f6dersjukhuset Karolinska Institutet Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Loghman","family":"Henareh","sequence":"additional","affiliation":[{"name":"Coronary Artery and Vascular Disease Heart and Vascular Theme Department of Medicine Karolinska Institute and Karolinska University Hospital Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulf","family":"Jensen","sequence":"additional","affiliation":[{"name":"Unit of Cardiology Department of Clinical Science and Education S\u00f6dersjukhuset Karolinska Institutet Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nanna","family":"Golster","sequence":"additional","affiliation":[{"name":"Department of Molecular Medicine and Surgery Karolinska Institutet Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrik","family":"Alstr\u00f6m","sequence":"additional","affiliation":[{"name":"Unit of Cardiology Department of Clinical Science and Education S\u00f6dersjukhuset Karolinska Institutet Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irene","family":"Santos\u2010Pardo","sequence":"additional","affiliation":[{"name":"Unit of Cardiology Department of Clinical Science and Education S\u00f6dersjukhuset Karolinska Institutet Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nils","family":"Witt","sequence":"additional","affiliation":[{"name":"Unit of Cardiology Department of Clinical Science and Education S\u00f6dersjukhuset Karolinska Institutet Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikolai","family":"Fedchenko","sequence":"additional","affiliation":[{"name":"Unit of Cardiology Department of Clinical Science and Education S\u00f6dersjukhuset Karolinska Institutet Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dimitrios","family":"Venetsanos","sequence":"additional","affiliation":[{"name":"Coronary Artery and Vascular Disease Heart and Vascular Theme Department of Medicine Karolinska Institute and Karolinska University Hospital Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olof","family":"Beck","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine Karolinska Institutet Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"van der Linden","sequence":"additional","affiliation":[{"name":"Department of Molecular Medicine and Surgery Karolinska Institutet Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehx419"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0904327"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.109.912550"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1080\/09537104.2016.1265921"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2013.01.024"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCINTERVENTIONS.112.972323"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2012.02.044"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1407024"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1300815"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2005.02.010"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1160\/TH15-12-0944"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehv547"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.117.031678"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/56.3.263"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1517\/17425255.2011.549824"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1177\/1060028016677310"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8159.2009.02177.x"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jchromb.2010.06.018"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.10497"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1093\/pch\/16.9.535"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.134.suppl_1.19115"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2016.04.004"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00392-015-0835-2"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehx393"},{"key":"e_1_3_2_26_2","unstructured":"Assessment report Relistor International non\u2010proprietary name: METHYLNALTREXONE BROMIDE Procedure No. EMEA\/H\/C\/000870\/II\/0030. 2015."},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2014.08.056"},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.thromres.2016.10.013"},{"key":"e_1_3_2_29_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejphar.2013.06.031"},{"key":"e_1_3_2_30_2","doi-asserted-by":"publisher","DOI":"10.1089\/jpm.2014.0362"}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.118.010152","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T11:18:27Z","timestamp":1715599107000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.118.010152"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,1,22]]},"references-count":29,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2019,1,22]]}},"alternative-id":["10.1161\/JAHA.118.010152"],"URL":"https:\/\/doi.org\/10.1161\/jaha.118.010152","relation":{},"ISSN":["2047-9980"],"issn-type":[{"value":"2047-9980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,1,22]]},"assertion":[{"value":"2018-09-10","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-12-10","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-01-13","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e010152"}}