В статье представлен клинический случай развития ишемической болезни сердца у молодого мужчины с анализом особенностей заболевания и проводимой терапией. Обсуждается вопрос ведения такого пациента с позиции современных рекомендаций и доказательной медицины. В статье приводятся доказательства важности контроля частоты сердечных сокращений у больных со стенокардией. Обсуждаются наиболее рациональные комбинации антиишемических препаратов для применения в клинической практике. Особый акцент сделан на селективном ингибиторе If-каналов и его клинических эффектах – хорошей антиангинальной активности и способности снижать риск сердечно-сосудистых осложнений.
The paper describes a clinical case of developing coronary heart disease in a young man, by analyzing the specific features of the disease and performed therapy. It discusses the management of this man according to the current recommendations and evidence-based medicine. The paper gives evidence for the importance of controlling heart rate in patients with angina pectoris. The most rational combinations of anti-ischemic agents for clinical application are discussed. Particular emphasis is laid on the selective If channel inhibitor ivabradine and its clinical effects: its good antianginal activity and ability to reduce the risk of cardiovascular events.
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Авторы
М.Г.Бубнова
ФГБУ Государственный научно-исследовательский центр профилактической медицины Минздрава РФ, Москва mbubnova@gnicpm.ru
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M.G.Bubnova
State Research Center for Preventive Medicine, Ministry of Health of the Russian Federation, Moscow mbubnova@gnicpm.ru