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Выбор антитромботической терапии у больных ишемической болезнью сердца и сахарным диабетом 2-го типа

https://doi.org/10.18087/cardio.2020.4.n1042

Полный текст:

Аннотация

В обзоре представлены распространенность сахарного диабета (СД) 2-го типа у больных ишемической болезнью сердца (ИБС), общность факторов риска возникновения, значительное ухудшение прогноза при их сочетании. Показаны патофизиологические механизмы дисфункции тромбоцитов и негативное изменение системы коагуляции у больных ИБС при наличии СД 2-го типа, что предопределяет активацию протромботического пути формирования гемостаза. Трудности оптимального выбора антитромботической терапии продемонстрированы как у больных СД 2-го типа без сердечно-сосудистых заболеваний в анамнезе, так и у больных ИБС в сочетании с СД 2-го типа. В обзоре обращается внимание на то, что данные рандомизированных клинических исследований (РКИ), выполненных у больных СД 2-го типа и острым коронарным синдромом или после коронарной реваскуляризации, нельзя экстраполировать на всю популяцию пациентов со стабильной ИБС. В настоящее время предпочтительным выбором антитромботической терапии у больных СД 2-го типа и стабильной ИБС является комбинация ривароксабана 2,5 мг 2 раза в сутки с ацетилсалициловой кислотой 100 мг / сут, обладающая максимальной клинической выгодой, по сравнению с другими стратегиями, представленными в РКИ.

Об авторах

Н. А. Козиолова
Федеральное государственное бюджетное образовательное учреждение высшего образования «Пермский государственный медицинский университет имени академика Е.А. Вагнера» Министерства здравоохранения Российской Федерации, Пермь, Россия
Россия
д.м.н., профессор, заведующая кафедрой пропедевтики внутренних болезней №2 ФГБОУ ВО ПГМУ им. ак. Е.А. Вагнера Минздрава России


П. Г. Караваев
Федеральное государственное бюджетное образовательное учреждение высшего образования «Пермский государственный медицинский университет имени академика Е.А. Вагнера» Министерства здравоохранения Российской Федерации, Пермь, Россия
Россия
ассистент  кафедры пропедевтики внутренних болезней №2 ФГБОУ ВО ПГМУ им. ак. Е.А. Вагнера» Минздрава России


А. С. Веклич
Федеральное государственное бюджетное образовательное учреждение высшего образования «Пермский государственный медицинский университет имени академика Е.А. Вагнера» Министерства
Россия
ассистент кафедры пропедевтики внутренних болезней №2  ФГБОУ ВО  ПГМУ им. ак. Е.А. Вагнера» Минздрава России


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Для цитирования:


Козиолова Н.А., Караваев П.Г., Веклич А.С. Выбор антитромботической терапии у больных ишемической болезнью сердца и сахарным диабетом 2-го типа. Кардиология. 2020;60(4):109-119. https://doi.org/10.18087/cardio.2020.4.n1042

For citation:


Koziolova N.A., Karavaev P.G., Veklich A.S. Choosing Antithrombotic Therapy in Patients with Coronary Heart Disease and Type 2 Diabetes Mellitus: How to Reduce the Risk of Death. Kardiologiia. 2020;60(4):109-119. (In Russ.) https://doi.org/10.18087/cardio.2020.4.n1042

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