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Обострение ишемической болезни сердца: баланс риска болезни и риска лечения
Обострение ишемической болезни сердца: баланс риска болезни и риска лечения
Бражник В.А., Затейщиков Д.А. Обострение ишемической болезни сердца: баланс риска болезни и риска лечения. Consilium Medicum. 2015; 1: 30–35. DOI: 10.26442/2075-1753_2015.1.30-35
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Аннотация
В обзоре описаны современные подходы к лечению больных, перенесших эпизод обострения ишемической болезни сердца. Суммированы данные исследований прямых пероральных ингибиторов гемостаза при этой патологии. Единственный препарат из этой группы ривароксабан, несмотря на некоторое увеличение частоты кровотечений, продемонстрировал эффективность в отношении снижения общей смертности у этих больных. Особое внимание сегодня отводится интервенционным вмешательствам, которые также могут служить источником дополнительных проблем, прежде всего тромбозов стентов. Ривароксабан оказался эффективным средством уменьшения частоты этого осложнения.
Ключевые слова: обострение ишемической болезни сердца, ингибиторы гемостаза, ривароксабан, тромбоз стента.
Ключевые слова: обострение ишемической болезни сердца, ингибиторы гемостаза, ривароксабан, тромбоз стента.
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This review describes current approaches to the treatment of patients who have had an episode of acute ischemic heart disease. Summarizes studies of oral direct inhibitors of hemostasis in this pathology. The only drug of this group rivaroxaban, despite a slight increase in the frequency of bleeding, has demonstrated efficacy in reducing total mortality in thesepatients. Particular attention is given today interventional procedures, which may also serve as a source of additional problems, especially stent thrombosis. Rivaroxaban has proved effective in reducing the frequency of this complication.
Keywords: aggravation of coronary heart disease, inhibitors of hemostasis, rivaroxaban, stent thrombosis.
Keywords: aggravation of coronary heart disease, inhibitors of hemostasis, rivaroxaban, stent thrombosis.
Полный текст
Список литературы
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24. Dangas GD, Claessen BE, Mehran R et al. Development and validation of a stent thrombosis risk score in patients with acute coronary syndromes. JACC Cardiovasc Interv 2012; 5 (11): 1097–105.
25. Steg PG, Harrington RA, Emanuelsson H et al for the P.S.G.Stent Thrombosis With Ticagrelor Versus Clopidogrel in Patients With Acute Coronary Syndromes: An Analysis From the Prospective, Randomized PLATO Trial. Circulation 2013; 128 (10): 1055–65.
26. Gibson CM, Chakrabarti AK, Mega J et al. Reduction of stent thrombosis in patients with acute coronary syndromes treated with rivaroxaban in ATLAS-ACS 2 TIMI 51. J Am Coll Cardiol 2013; 62 (4): 286–90.
27. Dewilde WJ, Oirbans T, Verheugt FW et al. Use of clopidogrel with or without aspirin in patients taking oral anticoagulant therapy and undergoing percutaneous coronary intervention: an open-label, randomised, controlled trial. Lancet 2013; 381 (9872): 1107–15.
2. Cannon CP, McCabe CH, Wilcox RG et al. Oral glycoprotein IIb/IIIa inhibition with orbofiban in patients with unstable coronary syndromes (OPUS-TIMI 16) trial. Circulation 2000; 102 (2): 149–56.
3. Mahaffey KW, Wojdyla DM, Carroll K et al. Ticagrelor compared with clopidogrel by geographic region in the Platelet Inhibition and Patient Outcomes (PLATO) trial. Circulation 2011; 124 (5): 544–54.
4. Hurlen M, Abdelnoor M, Smith P et al. Warfarin, aspirin, or both after myocardial infarction. N Engl J Med 2002; 347 (13): 969–74.
5. Wallentin L, Wilcox RG, Weaver WD et al. Oral ximelagatran for secondary prophylaxis after myocardial infarction: the ESTEEM randomised controlled trial. Lancet 2003; 362 (9386): 789–97.
6. Oldgren J, Budaj A, Granger CB et al. Dabigatran vs. placebo in patients with acute coronary syndromes on dual antiplatelet therapy: a randomized, double-blind, phase II trial. Eur Heart J 2011; 32 (22): 2781–9.
7. Douxfils J, Buckinx F, Mullier F et al. Dabigatran etexilate and risk of myocardial infarction, other cardiovascular events, major bleeding, and all-cause mortality: a systematic review and meta-analysis of randomized controlled trials. J Am Heart Assoc 2014, 3 (3): e000515.
8. Alexander JH, Becker RC, Bhatt DL et al. Apixaban, an oral, direct, selective factor Xa inhibitor, in combination with antiplatelet therapy after acute coronary syndrome: results of the Apixaban for Prevention of Acute Ischemic and Safety Events (APPRAISE) trial. Circulation 2009; 119 (22): 2877–85.
9. Alexander JH, Lopes RD, James S et al. Apixaban with antiplatelet therapy after acute coronary syndrome. N Engl J Med 2011; 365 (8): 699–708.
10. Hess CN, James S, Wojdyla DM et al. Apixaban Plus Mono versus Dual Antiplatelet Therapy After Acute Coronary Syndromes: Insights from the APPRAISE-2 Trial. Circulation 2014; 130 (Suppl. 2): A14643.
11. Loke YK, Pradhan S, Yeong JK, Kwok CS. Comparative coronary risks of apixaban, rivaroxaban and dabigatran: a meta-analysis and adjusted indirect comparison. Br J Clin Pharmacol 2014; 78 (4): 707–17.
12. Mega JL, Braunwald E, Mohanavelu S et al. Rivaroxaban versus placebo in patients with acute coronary syndromes (ATLAS ACS-TIMI 46): a randomised, double-blind, phase II trial. Lancet 2009; 374 (9683): 29–38.
13. Mega JL, Braunwald E, Wiviott SD et al. Rivaroxaban in Patients with a Recent Acute Coronary Syndrome. N Engl J Med 2012; 366 (1): 9–19.
14. Mauri L, Kereiakes DJ, Yeh RW et al. Twelve or 30 Months of Dual Antiplatelet Therapy after Drug-Eluting Stents. N Engl J Med 2014; 371 (23): 2155–66.
15. Reejhsinghani R, Lotfi AS. Prevention of stent thrombosis: challenges and solutions. Vasc Health Risk Manag 2015; 11: 93–106.
16. Iakovou I, Schmidt T, Bonizzoni E et al. Incidence, predictors, and outcome of thrombosis after successful implantation of drug-eluting stents. J Am Med Assoc 2005; 293 (17): 2126–30.
17. Kohn CG, Kluger J, Azeem M, Coleman CI. Short-term consequences of angiographically-confirmed coronary stent thrombosis. PLoS One 2013; 8 (10): e77330.
18. Cutlip DE, Windecker S, Mehran R et al. Clinical end points in coronary stent trials: a case for standardized definitions. Circulation 2007; 115 (17): 2344–51.
19. Yadav M, Genereux P., Palmerini T et al. SYNTAX score and the risk of stent thrombosis after percutaneous coronary intervention in patients with non-ST-segment elevation acute coronary syndromes: an ACUITY trial substudy. Catheter Cardiovascular Interv 2015; 85 (1): 1–10.
20. Finn AV, Joner M, Nakazawa G et al. Pathological correlates of late drug-eluting stent thrombosis: strut coverage as a marker of endothelialization. Circulation 2007; 115 (18): 2435–41.
21. Otsuka F, Nakano M, Ladich E et al. Pathologic Etiologies of Late and Very Late Stent Thrombosis following First-Generation Drug-Eluting Stent Placement. Thrombosis 2012; 2012: 608593.
22. Van Werkum JW, Heestermans AA, Zomer AC et al. Predictors of coronary stent thrombosis: the Dutch Stent Thrombosis Registry. J Am Coll Cardiol 2009; 53 (16): 1399–409.
23. Claessen BE, Henriques JP, Jaffer FA et al. Stent thrombosis: a clinical perspective. JACC Cardiovasc Interv 2014; 7 (10): 1081–92.
24. Dangas GD, Claessen BE, Mehran R et al. Development and validation of a stent thrombosis risk score in patients with acute coronary syndromes. JACC Cardiovasc Interv 2012; 5 (11): 1097–105.
25. Steg PG, Harrington RA, Emanuelsson H et al for the P.S.G.Stent Thrombosis With Ticagrelor Versus Clopidogrel in Patients With Acute Coronary Syndromes: An Analysis From the Prospective, Randomized PLATO Trial. Circulation 2013; 128 (10): 1055–65.
26. Gibson CM, Chakrabarti AK, Mega J et al. Reduction of stent thrombosis in patients with acute coronary syndromes treated with rivaroxaban in ATLAS-ACS 2 TIMI 51. J Am Coll Cardiol 2013; 62 (4): 286–90.
27. Dewilde WJ, Oirbans T, Verheugt FW et al. Use of clopidogrel with or without aspirin in patients taking oral anticoagulant therapy and undergoing percutaneous coronary intervention: an open-label, randomised, controlled trial. Lancet 2013; 381 (9872): 1107–15.
2. Cannon CP, McCabe CH, Wilcox RG et al. Oral glycoprotein IIb/IIIa inhibition with orbofiban in patients with unstable coronary syndromes (OPUS-TIMI 16) trial. Circulation 2000; 102 (2): 149–56.
3. Mahaffey KW, Wojdyla DM, Carroll K et al. Ticagrelor compared with clopidogrel by geographic region in the Platelet Inhibition and Patient Outcomes (PLATO) trial. Circulation 2011; 124 (5): 544–54.
4. Hurlen M, Abdelnoor M, Smith P et al. Warfarin, aspirin, or both after myocardial infarction. N Engl J Med 2002; 347 (13): 969–74.
5. Wallentin L, Wilcox RG, Weaver WD et al. Oral ximelagatran for secondary prophylaxis after myocardial infarction: the ESTEEM randomised controlled trial. Lancet 2003; 362 (9386): 789–97.
6. Oldgren J, Budaj A, Granger CB et al. Dabigatran vs. placebo in patients with acute coronary syndromes on dual antiplatelet therapy: a randomized, double-blind, phase II trial. Eur Heart J 2011; 32 (22): 2781–9.
7. Douxfils J, Buckinx F, Mullier F et al. Dabigatran etexilate and risk of myocardial infarction, other cardiovascular events, major bleeding, and all-cause mortality: a systematic review and meta-analysis of randomized controlled trials. J Am Heart Assoc 2014, 3 (3): e000515.
8. Alexander JH, Becker RC, Bhatt DL et al. Apixaban, an oral, direct, selective factor Xa inhibitor, in combination with antiplatelet therapy after acute coronary syndrome: results of the Apixaban for Prevention of Acute Ischemic and Safety Events (APPRAISE) trial. Circulation 2009; 119 (22): 2877–85.
9. Alexander JH, Lopes RD, James S et al. Apixaban with antiplatelet therapy after acute coronary syndrome. N Engl J Med 2011; 365 (8): 699–708.
10. Hess CN, James S, Wojdyla DM et al. Apixaban Plus Mono versus Dual Antiplatelet Therapy After Acute Coronary Syndromes: Insights from the APPRAISE-2 Trial. Circulation 2014; 130 (Suppl. 2): A14643.
11. Loke YK, Pradhan S, Yeong JK, Kwok CS. Comparative coronary risks of apixaban, rivaroxaban and dabigatran: a meta-analysis and adjusted indirect comparison. Br J Clin Pharmacol 2014; 78 (4): 707–17.
12. Mega JL, Braunwald E, Mohanavelu S et al. Rivaroxaban versus placebo in patients with acute coronary syndromes (ATLAS ACS-TIMI 46): a randomised, double-blind, phase II trial. Lancet 2009; 374 (9683): 29–38.
13. Mega JL, Braunwald E, Wiviott SD et al. Rivaroxaban in Patients with a Recent Acute Coronary Syndrome. N Engl J Med 2012; 366 (1): 9–19.
14. Mauri L, Kereiakes DJ, Yeh RW et al. Twelve or 30 Months of Dual Antiplatelet Therapy after Drug-Eluting Stents. N Engl J Med 2014; 371 (23): 2155–66.
15. Reejhsinghani R, Lotfi AS. Prevention of stent thrombosis: challenges and solutions. Vasc Health Risk Manag 2015; 11: 93–106.
16. Iakovou I, Schmidt T, Bonizzoni E et al. Incidence, predictors, and outcome of thrombosis after successful implantation of drug-eluting stents. J Am Med Assoc 2005; 293 (17): 2126–30.
17. Kohn CG, Kluger J, Azeem M, Coleman CI. Short-term consequences of angiographically-confirmed coronary stent thrombosis. PLoS One 2013; 8 (10): e77330.
18. Cutlip DE, Windecker S, Mehran R et al. Clinical end points in coronary stent trials: a case for standardized definitions. Circulation 2007; 115 (17): 2344–51.
19. Yadav M, Genereux P., Palmerini T et al. SYNTAX score and the risk of stent thrombosis after percutaneous coronary intervention in patients with non-ST-segment elevation acute coronary syndromes: an ACUITY trial substudy. Catheter Cardiovascular Interv 2015; 85 (1): 1–10.
20. Finn AV, Joner M, Nakazawa G et al. Pathological correlates of late drug-eluting stent thrombosis: strut coverage as a marker of endothelialization. Circulation 2007; 115 (18): 2435–41.
21. Otsuka F, Nakano M, Ladich E et al. Pathologic Etiologies of Late and Very Late Stent Thrombosis following First-Generation Drug-Eluting Stent Placement. Thrombosis 2012; 2012: 608593.
22. Van Werkum JW, Heestermans AA, Zomer AC et al. Predictors of coronary stent thrombosis: the Dutch Stent Thrombosis Registry. J Am Coll Cardiol 2009; 53 (16): 1399–409.
23. Claessen BE, Henriques JP, Jaffer FA et al. Stent thrombosis: a clinical perspective. JACC Cardiovasc Interv 2014; 7 (10): 1081–92.
24. Dangas GD, Claessen BE, Mehran R et al. Development and validation of a stent thrombosis risk score in patients with acute coronary syndromes. JACC Cardiovasc Interv 2012; 5 (11): 1097–105.
25. Steg PG, Harrington RA, Emanuelsson H et al for the P.S.G.Stent Thrombosis With Ticagrelor Versus Clopidogrel in Patients With Acute Coronary Syndromes: An Analysis From the Prospective, Randomized PLATO Trial. Circulation 2013; 128 (10): 1055–65.
26. Gibson CM, Chakrabarti AK, Mega J et al. Reduction of stent thrombosis in patients with acute coronary syndromes treated with rivaroxaban in ATLAS-ACS 2 TIMI 51. J Am Coll Cardiol 2013; 62 (4): 286–90.
27. Dewilde WJ, Oirbans T, Verheugt FW et al. Use of clopidogrel with or without aspirin in patients taking oral anticoagulant therapy and undergoing percutaneous coronary intervention: an open-label, randomised, controlled trial. Lancet 2013; 381 (9872): 1107–15.
________________________________________________
2. Cannon CP, McCabe CH, Wilcox RG et al. Oral glycoprotein IIb/IIIa inhibition with orbofiban in patients with unstable coronary syndromes (OPUS-TIMI 16) trial. Circulation 2000; 102 (2): 149–56.
3. Mahaffey KW, Wojdyla DM, Carroll K et al. Ticagrelor compared with clopidogrel by geographic region in the Platelet Inhibition and Patient Outcomes (PLATO) trial. Circulation 2011; 124 (5): 544–54.
4. Hurlen M, Abdelnoor M, Smith P et al. Warfarin, aspirin, or both after myocardial infarction. N Engl J Med 2002; 347 (13): 969–74.
5. Wallentin L, Wilcox RG, Weaver WD et al. Oral ximelagatran for secondary prophylaxis after myocardial infarction: the ESTEEM randomised controlled trial. Lancet 2003; 362 (9386): 789–97.
6. Oldgren J, Budaj A, Granger CB et al. Dabigatran vs. placebo in patients with acute coronary syndromes on dual antiplatelet therapy: a randomized, double-blind, phase II trial. Eur Heart J 2011; 32 (22): 2781–9.
7. Douxfils J, Buckinx F, Mullier F et al. Dabigatran etexilate and risk of myocardial infarction, other cardiovascular events, major bleeding, and all-cause mortality: a systematic review and meta-analysis of randomized controlled trials. J Am Heart Assoc 2014, 3 (3): e000515.
8. Alexander JH, Becker RC, Bhatt DL et al. Apixaban, an oral, direct, selective factor Xa inhibitor, in combination with antiplatelet therapy after acute coronary syndrome: results of the Apixaban for Prevention of Acute Ischemic and Safety Events (APPRAISE) trial. Circulation 2009; 119 (22): 2877–85.
9. Alexander JH, Lopes RD, James S et al. Apixaban with antiplatelet therapy after acute coronary syndrome. N Engl J Med 2011; 365 (8): 699–708.
10. Hess CN, James S, Wojdyla DM et al. Apixaban Plus Mono versus Dual Antiplatelet Therapy After Acute Coronary Syndromes: Insights from the APPRAISE-2 Trial. Circulation 2014; 130 (Suppl. 2): A14643.
11. Loke YK, Pradhan S, Yeong JK, Kwok CS. Comparative coronary risks of apixaban, rivaroxaban and dabigatran: a meta-analysis and adjusted indirect comparison. Br J Clin Pharmacol 2014; 78 (4): 707–17.
12. Mega JL, Braunwald E, Mohanavelu S et al. Rivaroxaban versus placebo in patients with acute coronary syndromes (ATLAS ACS-TIMI 46): a randomised, double-blind, phase II trial. Lancet 2009; 374 (9683): 29–38.
13. Mega JL, Braunwald E, Wiviott SD et al. Rivaroxaban in Patients with a Recent Acute Coronary Syndrome. N Engl J Med 2012; 366 (1): 9–19.
14. Mauri L, Kereiakes DJ, Yeh RW et al. Twelve or 30 Months of Dual Antiplatelet Therapy after Drug-Eluting Stents. N Engl J Med 2014; 371 (23): 2155–66.
15. Reejhsinghani R, Lotfi AS. Prevention of stent thrombosis: challenges and solutions. Vasc Health Risk Manag 2015; 11: 93–106.
16. Iakovou I, Schmidt T, Bonizzoni E et al. Incidence, predictors, and outcome of thrombosis after successful implantation of drug-eluting stents. J Am Med Assoc 2005; 293 (17): 2126–30.
17. Kohn CG, Kluger J, Azeem M, Coleman CI. Short-term consequences of angiographically-confirmed coronary stent thrombosis. PLoS One 2013; 8 (10): e77330.
18. Cutlip DE, Windecker S, Mehran R et al. Clinical end points in coronary stent trials: a case for standardized definitions. Circulation 2007; 115 (17): 2344–51.
19. Yadav M, Genereux P., Palmerini T et al. SYNTAX score and the risk of stent thrombosis after percutaneous coronary intervention in patients with non-ST-segment elevation acute coronary syndromes: an ACUITY trial substudy. Catheter Cardiovascular Interv 2015; 85 (1): 1–10.
20. Finn AV, Joner M, Nakazawa G et al. Pathological correlates of late drug-eluting stent thrombosis: strut coverage as a marker of endothelialization. Circulation 2007; 115 (18): 2435–41.
21. Otsuka F, Nakano M, Ladich E et al. Pathologic Etiologies of Late and Very Late Stent Thrombosis following First-Generation Drug-Eluting Stent Placement. Thrombosis 2012; 2012: 608593.
22. Van Werkum JW, Heestermans AA, Zomer AC et al. Predictors of coronary stent thrombosis: the Dutch Stent Thrombosis Registry. J Am Coll Cardiol 2009; 53 (16): 1399–409.
23. Claessen BE, Henriques JP, Jaffer FA et al. Stent thrombosis: a clinical perspective. JACC Cardiovasc Interv 2014; 7 (10): 1081–92.
24. Dangas GD, Claessen BE, Mehran R et al. Development and validation of a stent thrombosis risk score in patients with acute coronary syndromes. JACC Cardiovasc Interv 2012; 5 (11): 1097–105.
25. Steg PG, Harrington RA, Emanuelsson H et al for the P.S.G.Stent Thrombosis With Ticagrelor Versus Clopidogrel in Patients With Acute Coronary Syndromes: An Analysis From the Prospective, Randomized PLATO Trial. Circulation 2013; 128 (10): 1055–65.
26. Gibson CM, Chakrabarti AK, Mega J et al. Reduction of stent thrombosis in patients with acute coronary syndromes treated with rivaroxaban in ATLAS-ACS 2 TIMI 51. J Am Coll Cardiol 2013; 62 (4): 286–90.
27. Dewilde WJ, Oirbans T, Verheugt FW et al. Use of clopidogrel with or without aspirin in patients taking oral anticoagulant therapy and undergoing percutaneous coronary intervention: an open-label, randomised, controlled trial. Lancet 2013; 381 (9872): 1107–15.
Авторы
В.А.Бражник, Д.А.Затейщиков*
ГБУЗ Городская клиническая больница №51 Департамента здравоохранения г. Москвы. 121309, Россия, Москва, ул. Алябьева, д. 7/33
*dz@bk.ru
ГБУЗ Городская клиническая больница №51 Департамента здравоохранения г. Москвы. 121309, Россия, Москва, ул. Алябьева, д. 7/33
*dz@bk.ru
________________________________________________
V.A.Braznik, D.A.Zateyshchikov*
Healthcare City clinical hospital №51 of Moscow Healthcare department. 121309, Russian Federation, Moscow, ul. Alabieva, d. 7/33
*dz@bk.ru
Healthcare City clinical hospital №51 of Moscow Healthcare department. 121309, Russian Federation, Moscow, ul. Alabieva, d. 7/33
*dz@bk.ru
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