Morphine in acute coronary syndrome and myocardial infarction: pro et contra

The review summarizes the current literature data on the use of the morphine in patients with acute coronary syndrome and myocardial infarction. It briefly reports on the possibility of prescribing morphine in such clinical situations in accordance with the current guidance of the American College of Cardiology Foundation, the American Heart Association and the European Society of Cardiology. After describing the pharmacological properties of the morphine, including its effect on the heart, the positive effects of the drug are discussed in detail: pain relief, hemodynamic effects, and the alleged effect on myocardial remodeling. To form a complete understanding of the analyzed opioid drug, information on the effect of morphine on clinical outcomes − death, recurrence of myocardial infarction, stroke, bleeding is provided. Equally important is the section describing the interaction of morphine with antiplatelet drugs prescribed to the patients with acute coronary syndrome and myocardial infarction. In conclusion, the article discusses the necessary options for optimal pain relief in the patients with acute coronary syndrome and myocardial infarction, as well as the need to study new antiplatelet drugs.

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