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Двойная антитромбоцитарная терапия после инфаркта миокарда на примере сочетания ацетилсалициловой кислоты и тикагрелора: как долго, кому и в каких дозах
Двойная антитромбоцитарная терапия после инфаркта миокарда на примере сочетания ацетилсалициловой кислоты и тикагрелора: как долго, кому и в каких дозах
Аверков О.В., Вечорко В.И. Двойная антитромбоцитарная терапия после инфаркта миокарда на примере сочетания ацетилсалициловой кислоты и тикагрелора: как долго, кому и в каких дозах. Consilium Medicum. 2017; 19 (1): 25–29.
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Аннотация
В аналитической статье представлено современное состояние вторичной профилактики с помощью антитромбоцитарных средств у больных, перенесших инфаркт миокарда. Среди новшеств последних лет – возможность увеличения длительности двойной антитромбоцитарной терапии более 1 года. Обсуждаются компоненты для длительной двойной антитромбоцитарной терапии и критерии отбора больных для подобного лечения. По мнению авторов, наиболее обоснованно в дополнение к ацетилсалициловой кислоте использовать тикагрелор, имеющий статус приоритетного в раннем лечении инфаркта миокарда. Результаты исследования PEGASUS-TIMI 54 дают основания для эффективного продления двойной антитромбоцитарной терапии более 1 года, используя тикагрелор в уменьшенной дозе (60 мг 2 раза в день).
Ключевые слова: инфаркт миокарда, антитромбоцитарные средства, тикагрелор.
Ключевые слова: инфаркт миокарда, антитромбоцитарные средства, тикагрелор.
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The analytical article presents the current state of secondary prevention in patients after myocardial infarction with the help of antiplatelet agents. The possibility of prolonging the duration of dual antiplatelet therapy to more than 1 year is among the innovations of recent years. We have discussed the components of long-term dual antiplatelet therapy and patient selection criteria for this treatment. According to the author’s point of view it is necessary to use combination of ticagrelor and acetylsalicylic acid in the early treatment of myocardial infarction. The results from the PEGASUS TIMI 54 study give arguments for prolonging the duration of effective dual antiplatelet therapy to more than 1 year on using low-dose ticagrelor (60 mg twice daily).
Key words: myocardial infarction, antiplatelet agents, ticagrelor.
Key words: myocardial infarction, antiplatelet agents, ticagrelor.
Полный текст
Список литературы
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9. Bonaca MP, Bhatt DL, Cohen M et al. Long-term use of ticagrelor in patients with prior myocardial infarction. New Engl J Med 2015. DOI: 10156/NEJMoa1500857
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11. Levine GN, Bates ER, Bittl JA et al. ACC/AHA guideline focused update on duration of dual antiplatelet therapy in patients with coronary artery disease: a report of the American college of cardiology/American heart association task force on clinical practice guidelines: an update of the 2011 ACCF/AHA/SCAI guideline for percutaneous coronary intervention, 2011 ACCF/AHA guideline for coronary artery bypass graft surgery, 2012 ACC/AHA/ACP/AATS/PCNA/SCAI/STS guideline for the diagnosis and management of patients with stable ischemic heart disease, 2013 ACCF/AHA guideline for the management of ST-Elevation myocardial infarction, 2014 AHA/ACC guideline for the management of patients with Non-ST-Elevation Acute Coronary Syndromes, and 2014 ACC/AHA Guideline on Perioperative Cardiovascular Evaluation and Management of Patients Undergoing Noncardiac Surgery. Circulation 2016; 2016: e123–55.
12. Bueno H, Pocock S, Danchin N et al. International patterns of dual antiplatelet therapy duration after acute coronary syndromes. Heart 2016;0:1–7. DOI: 10.1136/heartjnl-2016-309509
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14. Mulukutla SR, Marroquin OC, Vlachos HA et al. Benefit of long-term dual anti-platelet therapy in patients treated with drug-eluting stents: from the NHLBI dynamic registry.
Am J Cardiol 2013; 111: 486–92.
15. Schiele F, Puymirat E, Bonello L et al. Impact of prolonged dual antiplatelet therapy after acute myocardial infarction on 5-year mortality in the FAST-MI 2005 registry. Int J Cardiol 2015; 187: 354–60.
16. Bonaca MP, Bhatt DL, Braunwald E et al. Design and rationale for the Prevention of Cardiovascular Events in Patients With Prior Heart Attack Using Ticagrelor Compared to Placebo on a Background of Aspirin-Thrombolysis in Myocardial Infarction 54 (PEGASUS-TIMI 54) trial. Am Heart J 2014; 167: 437–44.
17. Bonaca MP, Bhatt DL, Steg PG et al. Ischaemic risk and efficacy of ticagrelor in relation to time from P2Y12 inhibitor withdrawal in patients with prior myocardial infarction: Insights from PEGASUSTIMI 54. Eur Heart J 2016; 37: 1133–42.
18. Bagai A, Bhatt DL, Eikelboom JW et al. Individualizing Duration of Dual Antiplatelet Therapy After Acute Coronary Syndrome or Percutaneous Coronary Intervention. Circulation 2016; 133: 2094–8. DOI: 10.1161/CIRCULATIONAHA.115.021158
2. Chen ZM, Jiang LX, Chen YP et al. Addition of clopidogrel to aspirin in 45,852 patients with acute myocardial infarction: randomised placebo-controlled trial. Lancet 2005; 366: 1607–21.
3. Wiviott SD, Braunwald E, McCabe CH et al. Prasugrel versus clopidogrel in patients with acute coronary syndromes. N Engl J Med 2007; 357: 2001–15.
4. Wallentin L, Becker RC, Budaj A et al. Ticagrelor versus clopidogrel in patients with acute coronary syndromes. N Engl J Med 2009; 361. DOI: 10.1056/NEJMoa0904327
5. Steg G, James DK, Atar D et al. Acute Myocardial Infarction in patients presenting with ST-segment elevation (Management of). Eur Heart J 2012; 33: 2569–619.
6. O’Gara PT, Kushner FG, Ascheim DD et al. 2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction: executive summary: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation. 2013: published online before print December 17, 2012, 10.1161/CIR.0b013e3182742c84
7. Roffi M, Patrono C, Collet J-P et al. ESC guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation. Eur Heart J 2015; 2016: 267–315.
8. Amsterdam EA, Wenger NK, Brindis RG et al. 2014 AHA/ACC guideline for the management of patients with non-ST-elevation acute coronary syndromes: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation 2014; 130 (25): 2354–94.
9. Bonaca MP, Bhatt DL, Cohen M et al. Long-term use of ticagrelor in patients with prior myocardial infarction. New Engl J Med 2015. DOI: 10156/NEJMoa1500857
10. Udell JA, Bonaca MP, Collet JP et al. Longterm dual antiplatelet therapy for secondary prevention of cardiovascular events in the subgroup of patients with previous myocardial infarction: a collaborative meta-analysis of randomized trials. Eur Heart J 2016; 37: 390–9.
11. Levine GN, Bates ER, Bittl JA et al. ACC/AHA guideline focused update on duration of dual antiplatelet therapy in patients with coronary artery disease: a report of the American college of cardiology/American heart association task force on clinical practice guidelines: an update of the 2011 ACCF/AHA/SCAI guideline for percutaneous coronary intervention, 2011 ACCF/AHA guideline for coronary artery bypass graft surgery, 2012 ACC/AHA/ACP/AATS/PCNA/SCAI/STS guideline for the diagnosis and management of patients with stable ischemic heart disease, 2013 ACCF/AHA guideline for the management of ST-Elevation myocardial infarction, 2014 AHA/ACC guideline for the management of patients with Non-ST-Elevation Acute Coronary Syndromes, and 2014 ACC/AHA Guideline on Perioperative Cardiovascular Evaluation and Management of Patients Undergoing Noncardiac Surgery. Circulation 2016; 2016: e123–55.
12. Bueno H, Pocock S, Danchin N et al. International patterns of dual antiplatelet therapy duration after acute coronary syndromes. Heart 2016;0:1–7. DOI: 10.1136/heartjnl-2016-309509
13. Mehran R, Baber U, Steg PG et al. Cessation of dual antiplatelet treatment and cardiac events after percutaneous coronary intervention (PARIS): 2 year results from a prospective observational study. Lancet 2013; 382: 1714–22.
14. Mulukutla SR, Marroquin OC, Vlachos HA et al. Benefit of long-term dual anti-platelet therapy in patients treated with drug-eluting stents: from the NHLBI dynamic registry.
Am J Cardiol 2013; 111: 486–92.
15. Schiele F, Puymirat E, Bonello L et al. Impact of prolonged dual antiplatelet therapy after acute myocardial infarction on 5-year mortality in the FAST-MI 2005 registry. Int J Cardiol 2015; 187: 354–60.
16. Bonaca MP, Bhatt DL, Braunwald E et al. Design and rationale for the Prevention of Cardiovascular Events in Patients With Prior Heart Attack Using Ticagrelor Compared to Placebo on a Background of Aspirin-Thrombolysis in Myocardial Infarction 54 (PEGASUS-TIMI 54) trial. Am Heart J 2014; 167: 437–44.
17. Bonaca MP, Bhatt DL, Steg PG et al. Ischaemic risk and efficacy of ticagrelor in relation to time from P2Y12 inhibitor withdrawal in patients with prior myocardial infarction: Insights from PEGASUSTIMI 54. Eur Heart J 2016; 37: 1133–42.
18. Bagai A, Bhatt DL, Eikelboom JW et al. Individualizing Duration of Dual Antiplatelet Therapy After Acute Coronary Syndrome or Percutaneous Coronary Intervention. Circulation 2016; 133: 2094–8. DOI: 10.1161/CIRCULATIONAHA.115.021158
2. Chen ZM, Jiang LX, Chen YP et al. Addition of clopidogrel to aspirin in 45,852 patients with acute myocardial infarction: randomised placebo-controlled trial. Lancet 2005; 366: 1607–21.
3. Wiviott SD, Braunwald E, McCabe CH et al. Prasugrel versus clopidogrel in patients with acute coronary syndromes. N Engl J Med 2007; 357: 2001–15.
4. Wallentin L, Becker RC, Budaj A et al. Ticagrelor versus clopidogrel in patients with acute coronary syndromes. N Engl J Med 2009; 361. DOI: 10.1056/NEJMoa0904327
5. Steg G, James DK, Atar D et al. Acute Myocardial Infarction in patients presenting with ST-segment elevation (Management of). Eur Heart J 2012; 33: 2569–619.
6. O’Gara PT, Kushner FG, Ascheim DD et al. 2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction: executive summary: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation. 2013: published online before print December 17, 2012, 10.1161/CIR.0b013e3182742c84
7. Roffi M, Patrono C, Collet J-P et al. ESC guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation. Eur Heart J 2015; 2016: 267–315.
8. Amsterdam EA, Wenger NK, Brindis RG et al. 2014 AHA/ACC guideline for the management of patients with non-ST-elevation acute coronary syndromes: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation 2014; 130 (25): 2354–94.
9. Bonaca MP, Bhatt DL, Cohen M et al. Long-term use of ticagrelor in patients with prior myocardial infarction. New Engl J Med 2015. DOI: 10156/NEJMoa1500857
10. Udell JA, Bonaca MP, Collet JP et al. Longterm dual antiplatelet therapy for secondary prevention of cardiovascular events in the subgroup of patients with previous myocardial infarction: a collaborative meta-analysis of randomized trials. Eur Heart J 2016; 37: 390–9.
11. Levine GN, Bates ER, Bittl JA et al. ACC/AHA guideline focused update on duration of dual antiplatelet therapy in patients with coronary artery disease: a report of the American college of cardiology/American heart association task force on clinical practice guidelines: an update of the 2011 ACCF/AHA/SCAI guideline for percutaneous coronary intervention, 2011 ACCF/AHA guideline for coronary artery bypass graft surgery, 2012 ACC/AHA/ACP/AATS/PCNA/SCAI/STS guideline for the diagnosis and management of patients with stable ischemic heart disease, 2013 ACCF/AHA guideline for the management of ST-Elevation myocardial infarction, 2014 AHA/ACC guideline for the management of patients with Non-ST-Elevation Acute Coronary Syndromes, and 2014 ACC/AHA Guideline on Perioperative Cardiovascular Evaluation and Management of Patients Undergoing Noncardiac Surgery. Circulation 2016; 2016: e123–55.
12. Bueno H, Pocock S, Danchin N et al. International patterns of dual antiplatelet therapy duration after acute coronary syndromes. Heart 2016;0:1–7. DOI: 10.1136/heartjnl-2016-309509
13. Mehran R, Baber U, Steg PG et al. Cessation of dual antiplatelet treatment and cardiac events after percutaneous coronary intervention (PARIS): 2 year results from a prospective observational study. Lancet 2013; 382: 1714–22.
14. Mulukutla SR, Marroquin OC, Vlachos HA et al. Benefit of long-term dual anti-platelet therapy in patients treated with drug-eluting stents: from the NHLBI dynamic registry.
Am J Cardiol 2013; 111: 486–92.
15. Schiele F, Puymirat E, Bonello L et al. Impact of prolonged dual antiplatelet therapy after acute myocardial infarction on 5-year mortality in the FAST-MI 2005 registry. Int J Cardiol 2015; 187: 354–60.
16. Bonaca MP, Bhatt DL, Braunwald E et al. Design and rationale for the Prevention of Cardiovascular Events in Patients With Prior Heart Attack Using Ticagrelor Compared to Placebo on a Background of Aspirin-Thrombolysis in Myocardial Infarction 54 (PEGASUS-TIMI 54) trial. Am Heart J 2014; 167: 437–44.
17. Bonaca MP, Bhatt DL, Steg PG et al. Ischaemic risk and efficacy of ticagrelor in relation to time from P2Y12 inhibitor withdrawal in patients with prior myocardial infarction: Insights from PEGASUSTIMI 54. Eur Heart J 2016; 37: 1133–42.
18. Bagai A, Bhatt DL, Eikelboom JW et al. Individualizing Duration of Dual Antiplatelet Therapy After Acute Coronary Syndrome or Percutaneous Coronary Intervention. Circulation 2016; 133: 2094–8. DOI: 10.1161/CIRCULATIONAHA.115.021158
________________________________________________
2. Chen ZM, Jiang LX, Chen YP et al. Addition of clopidogrel to aspirin in 45,852 patients with acute myocardial infarction: randomised placebo-controlled trial. Lancet 2005; 366: 1607–21.
3. Wiviott SD, Braunwald E, McCabe CH et al. Prasugrel versus clopidogrel in patients with acute coronary syndromes. N Engl J Med 2007; 357: 2001–15.
4. Wallentin L, Becker RC, Budaj A et al. Ticagrelor versus clopidogrel in patients with acute coronary syndromes. N Engl J Med 2009; 361. DOI: 10.1056/NEJMoa0904327
5. Steg G, James DK, Atar D et al. Acute Myocardial Infarction in patients presenting with ST-segment elevation (Management of). Eur Heart J 2012; 33: 2569–619.
6. O’Gara PT, Kushner FG, Ascheim DD et al. 2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction: executive summary: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation. 2013: published online before print December 17, 2012, 10.1161/CIR.0b013e3182742c84
7. Roffi M, Patrono C, Collet J-P et al. ESC guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation. Eur Heart J 2015; 2016: 267–315.
8. Amsterdam EA, Wenger NK, Brindis RG et al. 2014 AHA/ACC guideline for the management of patients with non-ST-elevation acute coronary syndromes: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation 2014; 130 (25): 2354–94.
9. Bonaca MP, Bhatt DL, Cohen M et al. Long-term use of ticagrelor in patients with prior myocardial infarction. New Engl J Med 2015. DOI: 10156/NEJMoa1500857
10. Udell JA, Bonaca MP, Collet JP et al. Longterm dual antiplatelet therapy for secondary prevention of cardiovascular events in the subgroup of patients with previous myocardial infarction: a collaborative meta-analysis of randomized trials. Eur Heart J 2016; 37: 390–9.
11. Levine GN, Bates ER, Bittl JA et al. ACC/AHA guideline focused update on duration of dual antiplatelet therapy in patients with coronary artery disease: a report of the American college of cardiology/American heart association task force on clinical practice guidelines: an update of the 2011 ACCF/AHA/SCAI guideline for percutaneous coronary intervention, 2011 ACCF/AHA guideline for coronary artery bypass graft surgery, 2012 ACC/AHA/ACP/AATS/PCNA/SCAI/STS guideline for the diagnosis and management of patients with stable ischemic heart disease, 2013 ACCF/AHA guideline for the management of ST-Elevation myocardial infarction, 2014 AHA/ACC guideline for the management of patients with Non-ST-Elevation Acute Coronary Syndromes, and 2014 ACC/AHA Guideline on Perioperative Cardiovascular Evaluation and Management of Patients Undergoing Noncardiac Surgery. Circulation 2016; 2016: e123–55.
12. Bueno H, Pocock S, Danchin N et al. International patterns of dual antiplatelet therapy duration after acute coronary syndromes. Heart 2016;0:1–7. DOI: 10.1136/heartjnl-2016-309509
13. Mehran R, Baber U, Steg PG et al. Cessation of dual antiplatelet treatment and cardiac events after percutaneous coronary intervention (PARIS): 2 year results from a prospective observational study. Lancet 2013; 382: 1714–22.
14. Mulukutla SR, Marroquin OC, Vlachos HA et al. Benefit of long-term dual anti-platelet therapy in patients treated with drug-eluting stents: from the NHLBI dynamic registry.
Am J Cardiol 2013; 111: 486–92.
15. Schiele F, Puymirat E, Bonello L et al. Impact of prolonged dual antiplatelet therapy after acute myocardial infarction on 5-year mortality in the FAST-MI 2005 registry. Int J Cardiol 2015; 187: 354–60.
16. Bonaca MP, Bhatt DL, Braunwald E et al. Design and rationale for the Prevention of Cardiovascular Events in Patients With Prior Heart Attack Using Ticagrelor Compared to Placebo on a Background of Aspirin-Thrombolysis in Myocardial Infarction 54 (PEGASUS-TIMI 54) trial. Am Heart J 2014; 167: 437–44.
17. Bonaca MP, Bhatt DL, Steg PG et al. Ischaemic risk and efficacy of ticagrelor in relation to time from P2Y12 inhibitor withdrawal in patients with prior myocardial infarction: Insights from PEGASUSTIMI 54. Eur Heart J 2016; 37: 1133–42.
18. Bagai A, Bhatt DL, Eikelboom JW et al. Individualizing Duration of Dual Antiplatelet Therapy After Acute Coronary Syndrome or Percutaneous Coronary Intervention. Circulation 2016; 133: 2094–8. DOI: 10.1161/CIRCULATIONAHA.115.021158
Авторы
О.В.Аверков*, В.И.Вечорко
ГБУЗ «Городская клиническая больница №15 им. О.М.Филатова» Департамента здравоохранения г. Москвы. 111539, Россия, Москва, ул. Вешняковская, д. 23;
*oleg.averkov@gmail.com
ГБУЗ «Городская клиническая больница №15 им. О.М.Филатова» Департамента здравоохранения г. Москвы. 111539, Россия, Москва, ул. Вешняковская, д. 23;
*oleg.averkov@gmail.com
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O.V.Averkov*, V.I.Vechorko
O.M.Filatov City Clinical Hospital №15 of the Department of Health of Moscow. 111539, Russian Federation, Moscow, ul. Veshniakovskaia, d. 23;
*oleg.averkov@gmail.com
O.M.Filatov City Clinical Hospital №15 of the Department of Health of Moscow. 111539, Russian Federation, Moscow, ul. Veshniakovskaia, d. 23;
*oleg.averkov@gmail.com
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