hfbHealth, Food & BiotechnologyHealth, Food & Biotechnology2712-7648РОСБИОТЕХ10.36107/hfb.2021.i1.s92hfb-92Research ArticleЗДОРОВЬЕHEALTHМорфин при остром коронарном синдроме и инфаркте миокарда: pro et contraMorphine in acute coronary syndrome and myocardial infarction: pro et contrahttps://orcid.org/0000-0003-3611-1186ИгнатенкоГригорий АнатольевичIgnatenkoGrigoriy A.

Ректор ГОО ВПО ДОННМУ ИМЕНИ М. ГОРЬКОГО, заведующий кафедрой пропедевтики внутренних болезней, профессор, д.м.н., чл.-корр. НАМН Украины

gai-1959@mail.ruhttps://orcid.org/0000-0003-3984-8482ТарадинГеннадий ГеннадьевичTaradinGennadiy G.

заведующий кафедрой терапии им. проф. А.И. Дяыка ФИПО,

отдел кардиологии и кардиохирургии, старший научный сотрудник

taradin@inbox.ruhttps://orcid.org/0000-0003-2694-6614РакитскаяИрина ВалериевнаRakitskayaIrina V.

доцент кафедры терапии ФИПО им. проф. А.И. Дядыка, к.м.н.

rakytskaya@yandex.ruhttps://orcid.org/0000-0003-3813-8200ГнилицкаяВиктория БорисовнаGnilitskayaViktoriya B.

доцент кафедры терапии ФИПО им. проф. А.И. Дядыка, к.м.н.

viktoriya.gn@gmail.comКуликоваСветлана ОлеговнаKulikovaSvetlana O.Cooli_sv_oka1997@mail.ruГОО ВПО «Донецкий национальный медицинский университет имени М. Горького»УкраинаState Educational Organization of Higher Professional Education “M. Gorky Donetsk National Medical University”UkraineГОО ВПО "ДОННМУ ИМЕНИ М.ГОРЬКОГО" ГУ "Институт неотложной и восстановительной хирургии им. В.К. Гусака"УкраинаState Educational Organization of Higher Professional Education “M. Gorky Donetsk National Medical University”; State Institution “Institute of Urgent and Reconstructive Surgery named after V.K. Gusak”UkraineГОО ВПО "ДОННМУ ИМЕНИ М.ГОРЬКОГО"УкраинаState Educational Organization of Higher Professional Education “M. Gorky Donetsk National Medical University”Ukraine202127062021311329Copyright © Игнатенко Г.А., Тарадин Г.Г., Ракитская И.В., Гнилицкая В.Б., Куликова С.О., 20212021Игнатенко Г.А., Тарадин Г.Г., Ракитская И.В., Гнилицкая В.Б., Куликова С.О.Ignatenko G.A., Taradin G.G., Rakitskaya I.V., Gnilitskaya V.B., Kulikova S.O.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.hfb-journal.ru/jour/article/view/92

В обзоре обобщены данные литературы по применению морфина у пациентов с острым коронарным синдромом и инфарктом миокарда. Кратко сообщается о возможности назначения морфина в таких клинических ситуациях в соответствии с действующими рекомендациями Организации Американской Коллегии Кардиологов/Американской Ассоциации Сердца и Европейского Общества Кардиологов. После описания фармакологических свойств морфина, подробно обсуждаются его положительные эффекты: обезболивание, улучшение гемодинамики, предполагаемое влияние на ремоделирование миокарда. Для полноценного представления о препарате приводится информация о влиянии морфина на клинические исходы – смерть, рецидив инфаркта миокарда, инсульт, кровотечение. Обзор содержит важную информацию о взаимодействии морфина с антитромбоцитарными препаратами, назначаемыми пациентам с острым коронарным синдромом и инфарктом миокарда. В заключение статьи обсуждаются необходимые варианты оптимального обезболивания пациентов с острым коронарным синдромом и инфарктом миокарда, а также востребованность в изучении новых антитромбоцитарных препаратов в этих условиях.

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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The authors declare that there are no conflicts of interest present.