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Morphine and outcomes in acute decompensated heart failure: an ADHERE analysis
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  • Published on:
    Res omnes venena sunt, dosis sola facit venenum
    • Ulrich S. Schuler, Oncology and Palliative Care
    • Other Contributors:
      • Michelle Meredith-Stewart, Barbara Schubert, and Rainer Sabatowski

    Overwhelmed by the sheer number of patients included, one is tempted to accept the conclusions made Peacock et al. in their recent paper [1] on the perceived risks of morphine in acute decompensated heart failure (ADHF).

    However, in several ways their analysis is difficult to reconcile with published data and observations in the palliative care setting. It is surprising that in the rationale given for the admi...

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    Conflict of Interest:
    None declared.
  • Published on:
    Opiates should be avoided in acute decompensated heart failure


    We were pleased to read Peacock et al’s paper warning of the dangers of morphine therapy in acute decompensated heart failure. [1] This retrospective review was the largest yet performed, with nearly 150000 patients in the database. The most concerning finding was an increased risk of mortality with an odds ratio of 5, despite extensive risk adjustment. Their conclusion that a prospective trial is neede...

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    Conflict of Interest:
    None declared.