Despite advances in medical and interventional management of acute myocardial infarction, treatment of the associated chest pain has remained relatively unchanged since opioids were first utilized in the 1930’s. This dominance can be partially attributed to initial studies suggesting hemodynamic benefits with opioid treatment. However, delayed gastrointestinal absorption of P2Y₁₂ inhibitors due to opioids and the consequent impairment in antiplatelet activity of this established therapy is cause for concern. Coupled with the lack of randomized clinical trial evidence to support widespread opioid use, there is now an opportunity to re-evaluate our approach to analgesia in myocardial infarction. This review characterizes the mechanism of the opioid-P2Y₁₂ inhibitor interaction, strategies aimed at mitigating the interaction and appraises promising alternative agents to opioid therapy in patients with myocardial infarction.

尽管急性心肌梗塞的医学和介入治疗取得了进展，但自 1930 年代首次使用阿片类药物以来，相关胸痛的治疗一直保持相对不变。这种优势可以部分归因于初步研究表明阿片类药物治疗的血流动力学益处。然而，由于阿片类药物导致P2Y ₁₂抑制剂的胃肠道吸收延迟以及由此确立的疗法的抗血小板活性受损，令人担忧。再加上缺乏支持广泛使用阿片类药物的随机临床试验证据，现在有机会重新评估我们对心肌梗死镇痛的方法。本综述描述了阿片类药物-P2Y ₁₂的机制 抑制剂相互作用，旨在减轻相互作用的策略，并评估心肌梗死患者阿片类药物治疗的有希望的替代药物。