Роль блокаторов гликопротеина IIb / IIIa рецепторов тромбоцитов при современном лечении больных с острым коронарным синдромом

Современное лечение больных с острым коронарным синдромом (ОКС) включает двухкомпонентную антитромбоцитарную терапию ацетилсалициловой кислотой и ингибитором рецепторов P2Y12 тромбоцитов. При этом у больных без высокого риска кровотечений предпочтение отдается прасугрелу и тикагрелору, действие которых более выражено, в меньшей степени зависит от метаболизма у конкретного больного и наступает быстрее, чем у клопидогрела. Частота применения ингибиторов гликопротеина IIb / IIIa рецепторов тромбоцитов (ИГ IIb / IIIa) существенно сократилась. Однако эти препараты остаются актуальными при проведении чрескожных коронарных вмешательств у пациентов с высоким риском коронарного тромбоза, массивным тромбом в коронарной артерии, при тромботических осложнениях процедуры, феномене «no-reflow». Внутривенный путь введения ИГ IIb / IIIa обеспечивает их эффективность у больных с затруднением приема или нарушением абсорбции пероральных препаратов. В обзоре представлены клинико-фармакологические характеристики различных ИГ IIb / IIIa, данные рандомизированных клинических исследований и регистров последних лет, оценивающих результаты их использования у больных с ОКС.

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