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Современные представления о дезагрегантной терапии для больных с кардиоваскулярными заболеваниями - Научно-практический журнал Cardioсоматика Том 3, №4 (2012)
Современные представления о дезагрегантной терапии для больных с кардиоваскулярными заболеваниями
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Аннотация
Первое место в формировании показателей заболеваемости и смертности населения занимают сердечно-сосудистые и цереброваскулярные заболевания. Наиболее распространены заболевания, связанные с атеросклеротическим поражением артерий. В статье приведены результаты крупных многоцентровых рандомизированных плацебо-контролируемых исследований, в которых оценивалась эффективность дезагрегантов. Данная группа препаратов в терапии больных атеросклерозом или с факторами риска его развития достоверно снижает смертность, обусловленную атеротромбозом. Рассмотрены основные клинические состояния, при которых сохраняется высокий риск развития атеротромботических осложнений.
Ключевые слова: ацетилсалициловая кислота, клопидогрел, дезагрегантная терапия, факторы риска, артериальная гипертензия, ишемическая болезнь сердца, ишемический инсульт, сахарный диабет, фибрилляция предсердий.
Key words: acetylsalicylic acid, clopidogrel, antiplatelet therapy, risk factors, arterial hypertension, ischemic heart disease, ischemic stroke, diabetes mellitus, atrial fibrillation.
Ключевые слова: ацетилсалициловая кислота, клопидогрел, дезагрегантная терапия, факторы риска, артериальная гипертензия, ишемическая болезнь сердца, ишемический инсульт, сахарный диабет, фибрилляция предсердий.
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Key words: acetylsalicylic acid, clopidogrel, antiplatelet therapy, risk factors, arterial hypertension, ischemic heart disease, ischemic stroke, diabetes mellitus, atrial fibrillation.
Полный текст
Список литературы
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9. CAPRIE Steering Committee. A randomised, blinded, trial of clopidogrel versus aspirin in patients at risk of ischaemic events. Lancet 1996; 348 (9038): 1329–39.
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11. Dippel DW. The results of CAPRIE, IST and CAST. Clopidogrel vs. Aspirin in patients at risk of ischaemic events. International stroke trial. Chinese acute stroke trial. Thromb Res 1998; 92 (1 Suppl. 1): S13–6.
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14. AHA Chicago, 18 November 2002. Results of the CREDO study. Neth Heart J 2003; 11 (2): 104–5.
15. Steinhubl SR, Berger PB, Tift MJ et al for the CREDO Investigators. Early and sustained dual oral antiplatelet therapy following percutaneous coronary intervention. A randomized controlled trial. JAMA 2002; 288: 2411–20.
16. Mehta SR, Yusuf S, Peters RJG et al for the CURE trial investigators. Effects of pre-treatment with clopidogrel and aspirin followed by long-term therapy in patients undergoing percutaneous coronary intervention: the PCI-CURE study. Lancet 2001; 358: 527–33.
17. Serebruany VL. Paradoxical excess mortality in the PLATO trial should be independently verified. Thromb Haemost 2011; DOI:10.1160/TH10-12-0807.
18. Camm J, Kirchhof P, Gregory YH et al. Guidelines for the management of atrial Fibrillation. Eur Heart J 2010; 31: 2369–429.
19. Bhatt DL, Fox KA, Hacke W et al. CHARISMA Investigators. Clopidogrel and aspirin versus aspirin alone for the prevention of atherothrombotic events. N Engl J Med 2006; 354: 1706–17.
20. Cacoub PP, Bhatt DL, Steg PG et al. Patients with peripheral arterial disease in the CHARISMA trial. EHJ 30 (2): 192–201.
21. Hansson L, Zanchetti A, Carruthers SG et al. Effects of intensive blood-pressure lowering and low-dose aspirin in patients with hypertension: principal results of the Hypertension Optimal Treatment (HOT) randomised trial. The Lancet 1998; 351 (9118): 1755–62.
22. American Diabetes Association: Aspirin Therapy in Diabetes. Diabetes Care 2002; 25 (Suppl. 1): S78–79.
23. Gomez Y, Adams E, Hoogmartens J. Analysis of purity in 19 drug product tablets containing clopidogrel: 18 copies versus the original brand. J Pharm Biomed Analysis 2004; 34: 341–8.
2. Cattaneo M. New P2Y12 inhibitors. Circulation 2010; 121: 171–9.
3. Kushner FG, Hand M, Smith SCJ et al. 2009 focused updates: ACC/AHA guidelines for the management of patients with STelevation myocardial infarction (updating the 2004 guideline and 2007 focused update) and ACC/AHA/SCAI guidelines on percutaneous coronary intervention (updating the 2005 guideline and 2007 focused update) a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol 2009; 54: 2205–41.
4. Price MJ, Coleman JL, Steinhubl SR et al. Onset and offset of platelet inhibition after high-dose clopidogrel loading and standard daily therapy measured by a point-of-care assay in healthy volunteers. Am J Cardiol 2006; 98: 681–4.
5. Gurbel PA, Bliden KP, Butler K et al. Randomized double-blind assessment of the ONSET and OFFSET of the antiplatelet effects of ticagrelor versus clopidogrel in patients with stable coronary artery disease: the ONSET/OFFSET study. Circulation 2009; 120: 2577–85.
6. Antithrombotic Trialists (ATT) Collaboration. Aspirin in the primary and secondary prevention of vascular disease: collaborative meta–analysis of individual participant data from randomised trials. Lancet 2009; 373: 1849–60.
7. Hennekens CH. Update on aspirin in the treatment and prevention of cardiovascular disease. Am J Manag Care 2002; (Suppl. 22): S691–700.
8. Patrono C, Bachmann F, Baigent C et al. Expert Consensus document on the use of antiplatelet agents. Eur Heart J 2004; 25: 166–81.
9. CAPRIE Steering Committee. A randomised, blinded, trial of clopidogrel versus aspirin in patients at risk of ischaemic events. Lancet 1996; 348 (9038): 1329–39.
10. Harker LA, Boissel JP, Pilgrim AJ, Gent M. Comparative safety and tolerability of clopidogrel and aspirin: results from CAPRIE. CAPRIE Steering Committee and Investigators. Clopidogrel versus aspirin in patients at risk of ischaemic events. Drug Saf 21 (4): 325–35.
11. Dippel DW. The results of CAPRIE, IST and CAST. Clopidogrel vs. Aspirin in patients at risk of ischaemic events. International stroke trial. Chinese acute stroke trial. Thromb Res 1998; 92 (1 Suppl. 1): S13–6.
12. CURE Investigators. The clopidogrel in unstable angina to prevent recurrent events (CURE) trial programme. Eur Heart J 2000; 21: 2033–41.
13. The CURE Trial Investigators. Effects of clopidogrel in addition to aspirin in patients with acute coronary syndromes without ST-segment elevation. N Engl J Med 2001; 345: 494–502.
14. AHA Chicago, 18 November 2002. Results of the CREDO study. Neth Heart J 2003; 11 (2): 104–5.
15. Steinhubl SR, Berger PB, Tift MJ et al for the CREDO Investigators. Early and sustained dual oral antiplatelet therapy following percutaneous coronary intervention. A randomized controlled trial. JAMA 2002; 288: 2411–20.
16. Mehta SR, Yusuf S, Peters RJG et al for the CURE trial investigators. Effects of pre-treatment with clopidogrel and aspirin followed by long-term therapy in patients undergoing percutaneous coronary intervention: the PCI-CURE study. Lancet 2001; 358: 527–33.
17. Serebruany VL. Paradoxical excess mortality in the PLATO trial should be independently verified. Thromb Haemost 2011; DOI:10.1160/TH10-12-0807.
18. Camm J, Kirchhof P, Gregory YH et al. Guidelines for the management of atrial Fibrillation. Eur Heart J 2010; 31: 2369–429.
19. Bhatt DL, Fox KA, Hacke W et al. CHARISMA Investigators. Clopidogrel and aspirin versus aspirin alone for the prevention of atherothrombotic events. N Engl J Med 2006; 354: 1706–17.
20. Cacoub PP, Bhatt DL, Steg PG et al. Patients with peripheral arterial disease in the CHARISMA trial. EHJ 30 (2): 192–201.
21. Hansson L, Zanchetti A, Carruthers SG et al. Effects of intensive blood-pressure lowering and low-dose aspirin in patients with hypertension: principal results of the Hypertension Optimal Treatment (HOT) randomised trial. The Lancet 1998; 351 (9118): 1755–62.
22. American Diabetes Association: Aspirin Therapy in Diabetes. Diabetes Care 2002; 25 (Suppl. 1): S78–79.
23. Gomez Y, Adams E, Hoogmartens J. Analysis of purity in 19 drug product tablets containing clopidogrel: 18 copies versus the original brand. J Pharm Biomed Analysis 2004; 34: 341–8.
Авторы
А.А.Ломоносова*, Е.А.Золозова, Е.В.Саютина, В.В.Чигинева
ГБОУ ДПО Российская медицинская академия последипломного образования Минздрава РФ
*anastasia_los@mail.ru
Russian medical academy of postgraduate education
*anastasia_los@mail.ru
ГБОУ ДПО Российская медицинская академия последипломного образования Минздрава РФ
*anastasia_los@mail.ru
________________________________________________
Russian medical academy of postgraduate education
*anastasia_los@mail.ru
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