Применение статинов, антикоагулянтов, антиагрегантов и антиаритмических препаратов у пациентов с COVID-19

В статье обсуждаются актуальные вопросы лечения пациентов с COVID-19. Представлены современные данные о назначении статинов, антитромботических и антиаритмических препаратов. Подробно обсуждены особенности купирования нарушений ритма сердца у пациентов с коронавирусной инфекцией и межлекарственное взаимодействие антиаритмических и противовирусных препаратов. Представлены рекомендации по антитромботической терапии пациентов с COVID-19 на амбулаторном и госпитальном этапах лечения, а также после выписки больного из стационара. Обсуждены вопросы межлекарственного взаимодействия антитромботических и противовирусных препаратов.

1. Varga Z, Flammer AJ, Steiger P, Haberecker M, Andermatt R, Zinkernagel AS et al. Endothelial cell infection and endotheliitis in COVID-19. The Lancet. 2020;395(10234):1417–8. DOI: 10.1016/S0140-6736(20)30937-5

2. Connors JM, Levy JH. Thromboinflammation and the hypercoagulability of COVID‐19. Journal of Thrombosis and Haemostasis. 2020;jth.14849. [Epub ahead of print]. DOI: 10.1111/jth.14849

3. Madjid M, Safavi-Naeini P, Solomon SD, Vardeny O. Potential Effects of Coronaviruses on the Cardiovascular System: A Review. JAMA Cardiology. 2020; [Epub ahead of print]. DOI: 10.1001/jamacardio.2020.1286

4. Hu T, Chen B, Zhou S, Mao J. Simvastatin inhibits inflammatory response in lipopolysaccharide (LPS)-stimulated RAW264.7 macrophages through the microRNA-22/Cyr61 axis. International Journal of Clinical and Experimental Pathology. 2018;11(8):3925–33. PMID: 31949780

5. Gorabi AM, Kiaie N, Hajighasemi S, Banach M, Penson PE, Jamialahmadi T et al. Statin-Induced Nitric Oxide Signaling: Mechanisms and Therapeutic Implications. Journal of Clinical Medicine. 2019;8(12):2051. DOI: 10.3390/jcm8122051

6. Kunutsor SK, Seidu S, Khunti K. Statins and primary prevention of venous thromboembolism: a systematic review and meta-analysis. The Lancet Haematology. 2017;4(2):e83–93. DOI: 10.1016/S2352-3026(16)30184-3

7. Kunutsor SK, Seidu S, Khunti K. Statins and secondary prevention of venous thromboembolism: pooled analysis of published observational cohort studies. European Heart Journal. 2017;38(20):1608–12. DOI: 10.1093/eurheartj/ehx107

8. Nagashima T, Okazaki H, Yudoh K, Matsuno H, Minota S. Apoptosis of rheumatoid synovial cells by statins through the blocking of protein geranylgeranylation: A potential therapeutic approach to rheumatoid arthritis. Arthritis & Rheumatism. 2006;54(2):579–86. DOI: 10.1002/art.21564

9. Yuan S. Statins May Decrease the Fatality Rate of Middle East Respiratory Syndrome Infection. mBio. 2015;6(4):e01120. DOI: 10.1128/mBio.01120-15

10. Fedson DS. Treating influenza with statins and other immunomodulatory agents. Antiviral Research. 2013;99(3):417–35. DOI: 10.1016/j.antiviral.2013.06.018

11. Vandermeer ML, Thomas AR, Kamimoto L, Reingold A, Gershman K, Meek J et al. Association Between Use of Statins and Mortality Among Patients Hospitalized With Laboratory-Confirmed Influenza Virus Infections: A Multistate Study. Journal of Infectious Diseases. 2012;205(1):13–9. DOI: 10.1093/infdis/jir695

12. Massachusetts General Hospital. Hematology Recommendations and Dosing Guidelinesduring COVID-19. Version 8.0. 4/30/2020. Av. at: https://www.massgeneral.org/assets/MGH/pdf/news/coronavirus/guidance-from-mass-general-hematology.pdf.

13. Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J et al. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus–Infected Pneumonia in Wuhan, China. JAMA. 2020;323(11):1061–9. DOI: 10.1001/jama.2020.1585

14. Guo T, Fan Y, Chen M, Wu X, Zhang L, He T et al. Cardiovascular Implications of Fatal Outcomes of Patients With Coronavirus Disease 2019 (COVID-19). JAMA Cardiology. 2020;e201017. [Epub ahead of print]. DOI: 10.1001/jamacardio.2020.1017

15. Goyal P, Choi JJ, Pinheiro LC, Schenck EJ, Chen R, Jabri A et al. Clinical Characteristics of Covid-19 in New York City. New England Journal of Medicine. 2020;NEJMc2010419. [Epub ahead of print]. DOI: 10.1056/NEJMc2010419

16. European Society of Cardiology. ESC Guidance for the Diagnosis and Management of CV Disease during the COVID-19 Pandemic. Last updated on 21 April 2020. Av. at: https://www.escardio.org/Education/COVID-19-and-Cardiology/ESC-COVID-19-Guidance.

17. The Liverpool Drug Interaction Group. Liverpool COVID-19 Interactions. Detailed recommendations for interactions with experimental COVID-19 therapies. 2020. [Internet] Available at: https://www.covid19-druginteractions.org/

18. Kirchhof P, Benussi S, Kotecha D, Ahlsson A, Atar D, Casadei B et al. 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS. European Heart Journal. 2016;37(38):2893–962. DOI: 10.1093/eurheartj/ehw210

19. Xiong T-Y, Redwood S, Prendergast B, Chen M. Coronaviruses and the cardiovascular system: acute and long-term implications. European Heart Journal. 2020;41(19):1798–800. DOI: 10.1093/eurheartj/ehaa231

20. Кушаковский М.С., Гришкин Ю.Н. Аритмии сердца. Расстройства ритма и нарушения проводимости. Причины, механизмы, электрокардиографическая и электрофизиологическая диагностика, клиника, лечение: руководство для врачей. 4-е изд., испр. и доп. -СПб.: Фолиант, 2014. -720с. ISBN 978-5-93929-245-0

21. Heart Rhythm Society. HRS COVID-19 Task Force Update: April 21, 2020. General guidance for QTc monitoring in COVID-19 patients. Av. at: https://www.hrsonline.org/hrs-covid-19-task-force-updateapril-21-2020.

22. Министерство Здравоохранения Российской Федерации. Временные методические рекомендации. Профилактика, диагностика и лечение новой коронавирусной инфекции (COVID-2019). Версия 6 (28.04.2020). Доступно на: https://cтопкоронавирус.рф/ai/doc/194/attach/28042020_mR_COVID-19_v6.pdf

23. Шляхто Е.В., Конради А.О., Арутюнов Г.П., Арутюнов А.Г., Баутин А.Е., Бойцов С.А. и др. Руководство по диагностике и лечению болезней системы кровообращения в контексте пандемии COVID-19. Российский кардиологический журнал. 2020;25(3):129-48. DOI: 10.15829/1560-4071-2020-3-3801

24. Арутюнов Г.П., Тарловская Е.И., Козиолова Н.А., Болдина М.В., Батюшин М.М., Аметов А.С. и др. Согласованная позиция экспертов Евразийской ассоциации терапевтов по вопросам тактики ведения пациентов c коморбидной патологией, инфицированных SARS-Cov-2. Терапевтический архив. 2020;92(9). (в печати). DOI: 10.26442/00403660.2020.09.000703

25. Bikdeli B, Madhavan MV, Jimenez D, Chuich T, Dreyfus I, Driggin E et al. COVID-19 and Thrombotic or Thromboembolic Disease: Implications for Prevention, Antithrombotic Therapy, and Follow-up. Journal of the American College of Cardiology. 2020;S0735109720350087. [Epub ahead of print]. DOI: 10.1016/j.jacc.2020.04.031

26. Thachil J, Tang N, Gando S, Falanga A, Cattaneo M, Levi M et al. ISTH interim guidance on recognition and management of coagulopathy in COVID‐19. Journal of Thrombosis and Haemostasis. 2020;jth.14810. [Epub ahead of print]. DOI: 10.1111/jth.14810

27. Арутюнов Г.П., Козиолова Н.А., Тарловская Е.И., Арутюнов А.Г., Григорьева Н.Ю., Джунусбекова Г.А. и др. Согласованная позиция экспертов Евразийской ассоциации терапевтов по некоторым новым механизмам патогенеза COVID19: фокус на гемостаз, вопросы гемотрансфузии и систему транспорта газов крови. Кардиология. 2020;60(5):1-8. DOI: 10.18087/cardio.2020.5.n1132

28. Cohen AT, Spiro TE, Spyropoulos AC, DeSanctis YH, Homering M, Büller HR et al. D-dimer as a predictor of venous thromboembolism in acutely ill, hospitalized patients: a subanalysis of the randomized controlled MAGELLAN trial. Journal of Thrombosis and Haemostasis. 2014;12(4):479–87. DOI: 10.1111/jth.12515

29. Gibson C, Spyropoulos A, Cohen A, Hull R, Goldhaber S, Yusen R et al. The IMPROVEDD VTE Risk Score: Incorporation of D-Dimer into the IMPROVE Score to Improve Venous Thromboembolism Risk Stratification. TH Open. 2017;1(1):e56–65. DOI: 10.1055/s-0037-1603929

30. Oudkerk M, Büller HR, Kuijpers D, van Es N, Oudkerk SF, McLoud TC et al. Diagnosis, Prevention, and Treatment of Thromboembolic Complications in COVID-19: Report of the National Institute for Public Health of the Netherlands. Radiology. 2020;201629. [Epub ahead of print]. DOI: 10.1148/radiol.2020201629

31. Barbar S, Noventa F, Rossetto V, Ferrari A, Brandolin B, Perlati M et al. A risk assessment model for the identification of hospitalized medical patients at risk for venous thromboembolism: the Padua Prediction Score: Padua Prediction Score. Journal of Thrombosis and Haemostasis. 2010;8(11):2450–7. DOI: 10.1111/j.1538-7836.2010.04044.x

32. Cohen AT, Spiro TE, Büller HR, Haskell L, Hu D, Hull R et al. Rivaroxaban for Thromboprophylaxis in Acutely Ill Medical Patients. New England Journal of Medicine. 2013;368(6):513–23. DOI: 10.1056/NEJMoa1111096

33. Goldhaber SZ, Leizorovicz A, Kakkar AK, Haas SK, Merli G, Knabb RM et al. Apixaban versus Enoxaparin for Thromboprophylaxis in Medically Ill Patients. New England Journal of Medicine. 2011;365(23):2167–77. DOI: 10.1056/NEJMoa1110899

34. Tang N, Bai H, Chen X, Gong J, Li D, Sun Z. Anticoagulant treatment is associated with decreased mortality in severe coronavirus disease 2019 patients with coagulopathy. Journal of Thrombosis and Haemostasis. 2020;18(5):1094–9. DOI: 10.1111/jth.14817

35. Iba T, Levy JH, Warkentin TE, Thachil J, Poll T, Levi M et al. Diagnosis and management of sepsis‐induced coagulopathy and disseminated intravascular coagulation. Journal of Thrombosis and Haemostasis. 2019;17(11):1989–94. DOI: 10.1111/jth.14578

36. Kahn SR, Lim W, Dunn AS, Cushman M, Dentali F, Akl EA et al. Prevention of VTE in Nonsurgical Patients: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest. 2012;141(2):e195S-e226S. DOI: 10.1378/chest.11-2296

37. Hull RD, Schellong SM, Tapson VF, Monreal M, Samama MM, Nicol P et l. Extended-Duration Venous Thromboembolism Prophylaxis in Acutely Ill Medical Patients With Recently Reduced Mobility: A Randomized Trial. Annals of Internal Medicine. 2010;153(1):8. DOI: 10.7326/0003-4819-153-1-201007060-00004

38. Cohen AT, Harrington RA, Goldhaber SZ, Hull RD, Wiens BL, Gold A et al. Extended Thromboprophylaxis with Betrixaban in Acutely Ill Medical Patients. New England Journal of Medicine. 2016;375(6):534–44. DOI: 10.1056/NEJMoa1601747

39. Spyropoulos AC, Ageno W, Albers GW, Elliott CG, Halperin JL, Hiatt WR et al. Rivaroxaban for Thromboprophylaxis after Hospitalization for Medical Illness. New England Journal of Medicine. 2018;379(12):1118–27. DOI: 10.1056/NEJMoa1805090

40. Konstantinides SV, Meyer G, Becattini C, Bueno H, Geersing G-J, Harjola V-P et al. 2019 ESC Guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society (ERS). European Heart Journal. 2019;41(4):543–603. DOI: 10.1093/eurheartj/ehz405