Комбинированная антитромботическая терапия у больных со стабильным течением сердечно-сосудистых заболеваний, обусловленных атеросклерозом: какое направление показал COMPASS?
Аннотация
Современная вторичная профилактика у пациентов со стабильной ишемической болезнью сердца (ИБС) и/или заболеванием периферических артерий (ЗПА), включающая антитромбоцитарную монотерапию, ассоциируется со значительным остаточным риском развития повторных сердечно-сосудистых осложнений (ССО). Внедрение в практику результатов многих современных исследований по оценке эффективности вторичной профилактики атеротромбоза затруднительно. Дополнительное воздействие на коагуляцию крови способно играть ключевую роль в предупреждении атеротромбоза. В исследовании COMPASS у пациентов с ИБС и/или ЗПА добавление ривароксабана в дозе 2,5 мг 2 раза в день к ацетилсалициловой кислоте (АСК), по сравнению с АСК в виде монотерапии, значительно снижало риск смерти от сердечно-сосудистых осложнений, развития инфаркта миокарда или инсульта и смерти по любой причине. При комбинированной антитромботической терапии увеличивался риск больших, но не фатальных, или внутричерепных кровотечений. У больных с ЗПА дополнительно снижался риск тяжелых ишемических осложнений в области нижних конечностей, включая ампутации. По данным анализа в подгруппах исследования COMPASS, добавление ривароксабана в дозе 2,5 мг 2 раза в день к АСК может оказаться наиболее полезным для пациентов со стабильным атеросклеротическим заболеванием при высоком риске тяжелых ССО и без высокого риска кровотечений.
Об авторе
С. Г. Канорский
ФГБОУ ВО «Кубанский государственный медицинский университет» Минздрава России
Россия
Россия
Канорский Сергей Григорьевич
Краснодар
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Рецензия
При поддержке: Публикация подготовлена при поддержке АО «БАЙЕР», PP-XAR-RU-0259–1.
Для цитирования:
Канорский С.Г. Комбинированная антитромботическая терапия у больных со стабильным течением сердечно-сосудистых заболеваний, обусловленных атеросклерозом: какое направление показал COMPASS? Кардиология. 2020;60(2):131-141. https://doi.org/10.18087/cardio.2020.2.n943
For citation:
Kanorskii S.G. Combined Antithrombotic Therapy in Patients with a Stable Atherosclerotic Cardiovascular Diseases: What Direction did COMPASS Show? Kardiologiia. 2020;60(2):131-141. https://doi.org/10.18087/cardio.2020.2.n943
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