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Профилактика повторного ишемического инсульта
Профилактика повторного ишемического инсульта
Пилипович А.А. Профилактика повторного ишемического инсульта. Consilium Medicum. 2019; 21 (9): 33–38. DOI: 10.26442/20751753.2019.9.190571
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Аннотация
В России болезни системы кровообращения лидируют в структуре смертности, инсульт стоит на 2-м месте после инфаркта миокарда. Только 16–13% пациентов полностью выздоравливают после ишемического инсульта (ИИ) и возвращаются к прежнему образу жизни, большинство приобретают стойкую инвалидизацию или умирают. Примерно у 1/2 пациентов, переживших ИИ или транзиторную ишемическую атаку (ТИА), в течение нескольких дней или недель случается повторный инсульт. Значительное число рецидивов инсульта может быть предотвращено современными методами вторичной профилактики. В статье обсуждается тактика управления факторами риска и антитромботической терапии с целью профилактики рецидивирующего ИИ (РИИ), основанная на рекомендациях Американской кардиологической ассоциации (AHA) и Американской ассоциации инсульта (ASA), с акцентом на лечение некардиоэмболического инсульта. Предотвращение ТИА и ИИ одинаково важно, и текущие рекомендации AHA/ASA применяются к обоим. Рассмотрены варианты профилактики РИИ с помощью антитромботической терапии (препаратами ацетилсалициловая кислота, клопидогрел, дипиридамол и их сочетаниями), описаны показания, побочные эффекты, эффективность и переносимость, терапевтические дозировки препаратов, согласно данным доказательной медицины.
Ключевые слова: ишемический инсульт, рецидивирующий инсульт, профилактика повторного инсульта, антиагреганты, ацетилсалициловая кислота.
Ключевые слова: ишемический инсульт, рецидивирующий инсульт, профилактика повторного инсульта, антиагреганты, ацетилсалициловая кислота.
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Cardiovascular disorders are one of the primary mortality causes in Russia. Among them stroke has the second place after acute myocardial infarction. Only 16–13% of patients make a full recovery after ischemic stroke (IS) and return to their former way of life. In most of the patients disease results in disability or death. About 1/2 of IS of transient ischemic attack (TIA) survivors have a recurrent stroke in several days of weeks. A considerable number of recurrent strokes can be prevented with modern methods of secondary prevention. The article discusses tactics of risk factors control and antiplatelet therapy use in prevention of recurrent IS (RIS) based on American Heart Association (AHA) and American Stroke Association (ASA) guidelines with the focus on noncardioembolic stroke treatment. TIA and IS prevention is equally important and modern AHA/ASA guidelines are used in both. Alternatives of RIS prevention with the use of antiplatelet therapy (medications acetylsalicylic acid, clopidogrel, dipiridamol and their combinations); indications, adverse effects, effectiveness and safety, therapeutic dosages are described according to evidence based medicine data.
Key words: ischemic stroke, recurrent stroke, recurrent stroke prevention, antiplatelet therapy, acetylsalicylic acid.
Key words: ischemic stroke, recurrent stroke, recurrent stroke prevention, antiplatelet therapy, acetylsalicylic acid.
Полный текст
Список литературы
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51. Chimowitz MI, Lynn MJ, Howlett-Smith H et al.; Warfarin-Aspirin Symptomatic Intracranial Disease Trial Investigators. Comparison of warfarin and aspirin for symptomatic intracranial arterial stenosis. N Engl J Med 2005; 352 (13): 1305–16.
2. Arsava EM, Kim GM, Oliveira-Filho J et al. Prediction of early recurrence after acute ischemic stroke. JAMA Neurol 2016; 73 (4): 396–401.
3. Mozaffarian D, Benjamin EJ, Go AS et al.; American Heart Association Statistics Committee; Stroke Statistics Subcommittee. Heart disease and stroke statistics-2016 update: a report fr om the American Heart Association. Circulation 2016; 133 (4): e38–e360.
4. Kernan WN, Ovbiagele B, Black HR et al.; American Heart Association Stroke Council, Council on Cardiovascular and Stroke Nursing, Council on Clinical Cardiology, and Council on Peripheral Vascular Disease. Guidelines for the prevention of stroke in patients with stroke and transient ischemic attack: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke 2014; 45 (7): 2160–236.
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6. PATS Collaborating Group. Post-stroke antihypertensive treatment study. A preliminary result. Chin Med J (Engl) 1995; 108 (9): 710–7.
7. PROGRESS Collaborative Group. Randomised trial of a perindopril-based blood-pressure-lowering regimen among 6,105 individuals with previous stroke or transient ischaemic attack. Lancet 2001; 358 (9287): 1033–41.
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9. Stone NJ, Robinson JG, Lichtenstein AH et al.; 2013 ACC/AHA Cholesterol Guideline Panel. Treatment of blood cholesterol to reduce atherosclerotic cardiovascular disease risk in adults: synopsis of the 2013 American College of Cardiology/American Heart Association cholesterol guideline. Ann Intern Med 2014; 160 (5): 339–43.
10. Amarenco P, Bogousslavsky J, Callahan A III et al.; Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL) Investigators. High-dose atorvastatin after stroke or transient ischemic attack. N Engl J Med 2006; 355 (6): 549–59.
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12. Karam JG, Loney-Hutchinson L, McFarlane SI. High-dose atorvastatin after stroke or transient ischemic attack: The Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL) Investigators. J Cardiometab Syndr 2008; 3 (1): 68–9.
13. Joseph JP, Afonso M, Berdaï D et al. Benefits and risks for primary prevention with statins in the elderly. Presse Med 2015; 44 (12 pt 1): 1219–25.
14. Kernan WN, Inzucchi SE, Sawan C et al. Obesity: a stubbornly obvious target for stroke prevention. Stroke 2013; 44 (1): 278–86.
15. Ruland S, Hung E, Richardson D et al.; African American Antiplatelet Stroke Prevention Study Investigators. Impact of obesity and the metabolic syndrome on risk factors in African American stroke survivors: a report from the AAASPS. Arch Neurol 2005; 62 (3): 386–90.
16. Ovbiagele B, Bath PM, Cotton D et al. Obesity and recurrent vascular risk after a recent ischemic stroke. Stroke 2011; 42 (12): 3397–402.
17. Doehner W, Schenkel J, Anker SD et al. Overweight and obesity are associated with improved survival, functional outcome, and stroke recurrence after acute stroke or transient ischaemic attack: observations from the TEMPiS trial. Eur Heart J 2013; 34 (4): 268–77.
18. Vemmos K, Ntaios G, Spengos K et al. Association between obesity and mortality after acute first-ever stroke: the obesity-stroke paradox. Stroke 2011; 42 (1): 30–6.
19. Epstein LJ, Kristo D, Strollo PJJr et al.; Adult Obstructive Sleep Apnea Task Force of the American Academy of Sleep Medicine. Clinical guideline for the evaluation, management and long-term care of obstructive sleep apnea in adults. J Clin Sleep Med 2009; 5 (3): 263–76.
20. Putaala J, Kurkinen M, Tarvos V et al. Silent brain infarcts and leukoaraiosis in young adults with first-ever ischemic stroke. Neurology 2009; 72 (21): 1823–9.
21. Mendis S, Abegunde D, Yusuf S et al. WHO study on prevention of recurrences of myocardial infarction and stroke (WHO-PREMISE). Bull World Health Organ 2005; 83 (11): 820–9.
22. Kaplan RC, Tirschwell DL, Longstreth WTJr et al. Vascular events, mortality, and preventive therapy following ischemic stroke in the elderly. Neurology 2005; 65 (6): 835–42.
23. Mostofsky E, Burger MR, Schlaug G et al. Alcohol and acute ischemic stroke onset: the stroke onset study. Stroke 2010; 41 (9): 1845–9.
24. MacKay-Lyons M, Gubitz G, Giacomantonio N et al. Program of rehabilitative exercise and education to avert vascular events after non-disabling stroke or transient ischemic attack (PREVENT Trial): a multi-centred, randomised controlled trial. BMC Neurol 2010; 10: 122.
25. Prior PL, Hachinski V, Unsworth K et al. Comprehensive cardiac rehabilitation for secondary prevention after transient ischemic attack or mild stroke: I: feasibility and risk factors. Stroke 2011; 42 (11): 3207–13.
26. Levin O.S., Bril' E.V. Pervichnaia i vtorichnaia profilaktika insul'ta. Sovremennaia terapiia v psikhiatrii i nevrologii. 2016; 1: 4–7 (in Russian).
27. Antithrombotic Trialists' Collaboration. Collaborative meta-analysis of randomised trials of antiplatelet therapy for prevention of death, myocardial infarction, and stroke in high risk patients. BMJ 2002; 324 (7329): 71–86.
28. Dickerson LM, Carek PJ, Quattlebaum RG. Prevention of recurrent ischemic stroke. Am Fam Physician 2007; 76 (3): 382–8.
29. Millard MA, Hernandez-Vila EA. What Do the Guidelines Really Say About Aspirin? Texas Heart Institute J 2018; 45 (4): 228–9.
30. Arnett et al. ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease. 2019.
31. Antitromboticheskaia terapiia u bol'nykh so stabil'nymi proiavleniiami aterotromboza. Rossiiskie rekomendatsii. Kardiovask. terapiia i profilaktika. 2009; 8 (Pril. 6): 20 (in Russian).
32. Farrell B, Godwin J, Richards S, Warlow C. The United Kingdom transient ischaemic attack (UK-TIA) aspirin trial: final results. J Neurol Neurosurg Psychiatry 1991; 54 (12): 1044–54.
33. The Dutch TIA Trial Study Group. A comparison of two doses of aspirin (30 mg vs. 283 mg a day) in patients after a transient ischemic attack or minor ischemic stroke. N Engl J Med 1991; 325 (18): 1261–6.
34. The Canadian Cooperative Study Group. A randomized trial of aspirin and sulfinpyrazone in threatened stroke. N Engl J Med 1978; 299 (2): 53–9.
35. Johnson ES, Lanes SF, Wentworth CE III et al. A metaregression analysis of the dose-response effect of aspirin on stroke. Arch Intern Med 1999; 159 (11): 1248–53.
36. The SALT Collaborative Group. Swedish Aspirin Low-Dose Trial (SALT) of 75 mg aspirin as secondary prophylaxis after cerebrovascular ischaemic events. Lancet 1991; 338 (8779): 1345–9.
37. Drepper MD, Spahr L, Frossard JL. Clopidogrel and proton pump inhibitors – wh ere do we stand in 2012? World J Gastroenterol 2012; 18 (18): 2161–71.
38. Diener HC, Bogousslavsky J, Brass LM et al.; MATCH Investigators. Aspirin and clopidogrel compared with clopidogrel alone after recent ischaemic stroke or transient ischaemic attack in high-risk patients (MATCH): randomised, double-blind, placebo-controlled trial. Lancet 2004; 364 (9431): 331–7.
39. Lavie CJ, Howden CW, Scheiman J, Tursi J. Upper Gastrointestinal Toxicity Associated With Long-Term Aspirin Therapy: Consequences and Prevention. Curr Probl Cardiol 2017; 42: 146–64.
40. Namio Uemura, Kentaro Sugano, Hideyuki Hiraishi et al. Risk factor profiles, drug usage, and prevalence of aspirin-associated gastroduodenal injuries among high-risk cardiovascular Japanese patients: the results from the MAGIC study. J Gastroenterol 2014; 49: 814–24.
41. Van Hecken A, Juliano ML, Depre M et al. Effects of enteric-coated, low-dose aspirin on parameters of platelet function. Aliment Pharmacol Ther 2002; 16: 1683–8.
42. Mega JL, Close SL, Wiviott SD et al. Cytochrome p-450 polymorphisms and response to clopidogrel. N Engl J Med 2009; 360 (4): 354–62.
43. Nai-Fang Chi, Chi-Pang Wen, Chung-Hsiang Liu et al. Comparison Between Aspirin and Clopidogrel in Secondary Stroke Prevention Based on Real-World Data. J Am Heart Assoc 2018; 7: e009856.
44. Pezalla E, Day D, Pulliadath I. Initial assessment of clinical impact of a drug interaction between clopidogrel and proton pump inhibitors. J Am Coll Cardiol. 2008; 52(12): 1038–1039.
45. Wang Y, Pan Y, Zhao X et al.; CHANCE Investigators. Clopidogrel with aspirin in acute minor stroke or transient ischemic attack (CHANCE) trial: one-year outcomes. Circulation 2015; 132 (1): 40–6.
46. 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 (16): 1706–17.
47. The ESPS Group. The European Stroke Prevention Study (ESPS). Principal end-points. Lancet 1987; 2 (8572): 1351–4.
48. Diener HC, Cunha L, Forbes C et al. European Stroke Prevention Study. 2. Dipyridamole and acetylsalicylic acid in the secondary prevention of stroke. J Neurol Sci 1996; 143 (1–2): 1–13.
49. The Stroke Prevention in Reversible Ischemia Trial (SPIRIT) Study Group. A randomized trial of anticoagulants versus aspirin after cerebral ischemia of presumed arterial origin. Ann Neurol 1997; 42 (6): 857–65.
50. Halkes PH, van Gijn J, Kappelle LJ et al.; ESPRIT Study Group. Medium intensity oral anticoagulants versus aspirin after cerebral ischaemia of arterial origin (ESPRIT): a randomised controlled trial. Lancet Neurol 2007; 6 (2): 115–24.
51. Chimowitz MI, Lynn MJ, Howlett-Smith H et al.; Warfarin-Aspirin Symptomatic Intracranial Disease Trial Investigators. Comparison of warfarin and aspirin for symptomatic intracranial arterial stenosis. N Engl J Med 2005; 352 (13): 1305–16.
[Suslina Z.A., Varakin Iu.Ia. Clinical guidelines for the early diagnosis, treatment and prevention of cerebrovascular disease. Moscow: MEDpress-inform, 2015 (in Russian).]
2. Arsava EM, Kim GM, Oliveira-Filho J et al. Prediction of early recurrence after acute ischemic stroke. JAMA Neurol 2016; 73 (4): 396–401.
3. Mozaffarian D, Benjamin EJ, Go AS et al.; American Heart Association Statistics Committee; Stroke Statistics Subcommittee. Heart disease and stroke statistics-2016 update: a report fr om the American Heart Association. Circulation 2016; 133 (4): e38–e360.
4. Kernan WN, Ovbiagele B, Black HR et al.; American Heart Association Stroke Council, Council on Cardiovascular and Stroke Nursing, Council on Clinical Cardiology, and Council on Peripheral Vascular Disease. Guidelines for the prevention of stroke in patients with stroke and transient ischemic attack: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke 2014; 45 (7): 2160–236.
5. Oza R, Rundell K, Garcellano M. Recurrent Ischemic Stroke: Strategies for Preventio Am Fam Physician 2017; 96 (7): 436–40.
6. PATS Collaborating Group. Post-stroke antihypertensive treatment study. A preliminary result. Chin Med J (Engl) 1995; 108 (9): 710–7.
7. PROGRESS Collaborative Group. Randomised trial of a perindopril-based blood-pressure-lowering regimen among 6,105 individuals with previous stroke or transient ischaemic attack. Lancet 2001; 358 (9287): 1033–41.
8. James PA, Oparil S, Carter BL et al. 2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8). JAMA 2014; 311 (5): 507–20.
9. Stone NJ, Robinson JG, Lichtenstein AH et al.; 2013 ACC/AHA Cholesterol Guideline Panel. Treatment of blood cholesterol to reduce atherosclerotic cardiovascular disease risk in adults: synopsis of the 2013 American College of Cardiology/American Heart Association cholesterol guideline. Ann Intern Med 2014; 160 (5): 339–43.
10. Amarenco P, Bogousslavsky J, Callahan A III et al.; Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL) Investigators. High-dose atorvastatin after stroke or transient ischemic attack. N Engl J Med 2006; 355 (6): 549–59.
11. Naci H, Brugts JJ, Fleurence R, Ades AE. Comparative effects of statins on major cerebrovascular events: a multiple-treatments meta-analysis of placebo-controlled and active-comparator trials. QJM 2013; 106 (4): 299–306.
12. Karam JG, Loney-Hutchinson L, McFarlane SI. High-dose atorvastatin after stroke or transient ischemic attack: The Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL) Investigators. J Cardiometab Syndr 2008; 3 (1): 68–9.
13. Joseph JP, Afonso M, Berdaï D et al. Benefits and risks for primary prevention with statins in the elderly. Presse Med 2015; 44 (12 pt 1): 1219–25.
14. Kernan WN, Inzucchi SE, Sawan C et al. Obesity: a stubbornly obvious target for stroke prevention. Stroke 2013; 44 (1): 278–86.
15. Ruland S, Hung E, Richardson D et al.; African American Antiplatelet Stroke Prevention Study Investigators. Impact of obesity and the metabolic syndrome on risk factors in African American stroke survivors: a report from the AAASPS. Arch Neurol 2005; 62 (3): 386–90.
16. Ovbiagele B, Bath PM, Cotton D et al. Obesity and recurrent vascular risk after a recent ischemic stroke. Stroke 2011; 42 (12): 3397–402.
17. Doehner W, Schenkel J, Anker SD et al. Overweight and obesity are associated with improved survival, functional outcome, and stroke recurrence after acute stroke or transient ischaemic attack: observations from the TEMPiS trial. Eur Heart J 2013; 34 (4): 268–77.
18. Vemmos K, Ntaios G, Spengos K et al. Association between obesity and mortality after acute first-ever stroke: the obesity-stroke paradox. Stroke 2011; 42 (1): 30–6.
19. Epstein LJ, Kristo D, Strollo PJJr et al.; Adult Obstructive Sleep Apnea Task Force of the American Academy of Sleep Medicine. Clinical guideline for the evaluation, management and long-term care of obstructive sleep apnea in adults. J Clin Sleep Med 2009; 5 (3): 263–76.
20. Putaala J, Kurkinen M, Tarvos V et al. Silent brain infarcts and leukoaraiosis in young adults with first-ever ischemic stroke. Neurology 2009; 72 (21): 1823–9.
21. Mendis S, Abegunde D, Yusuf S et al. WHO study on prevention of recurrences of myocardial infarction and stroke (WHO-PREMISE). Bull World Health Organ 2005; 83 (11): 820–9.
22. Kaplan RC, Tirschwell DL, Longstreth WTJr et al. Vascular events, mortality, and preventive therapy following ischemic stroke in the elderly. Neurology 2005; 65 (6): 835–42.
23. Mostofsky E, Burger MR, Schlaug G et al. Alcohol and acute ischemic stroke onset: the stroke onset study. Stroke 2010; 41 (9): 1845–9.
24. MacKay-Lyons M, Gubitz G, Giacomantonio N et al. Program of rehabilitative exercise and education to avert vascular events after non-disabling stroke or transient ischemic attack (PREVENT Trial): a multi-centred, randomised controlled trial. BMC Neurol 2010; 10: 122.
25. Prior PL, Hachinski V, Unsworth K et al. Comprehensive cardiac rehabilitation for secondary prevention after transient ischemic attack or mild stroke: I: feasibility and risk factors. Stroke 2011; 42 (11): 3207–13.
26. Левин О.С., Бриль Е.В. Первичная и вторичная профилактика инсульта. Современная терапия в психиатрии и неврологии. 2016; 1: 4–7.
[Levin O.S., Bril' E.V. Pervichnaia i vtorichnaia profilaktika insul'ta. Sovremennaia terapiia v psikhiatrii i nevrologii. 2016; 1: 4–7 (in Russian).]
27. Antithrombotic Trialists' Collaboration. Collaborative meta-analysis of randomised trials of antiplatelet therapy for prevention of death, myocardial infarction, and stroke in high risk patients. BMJ 2002; 324 (7329): 71–86.
28. Dickerson LM, Carek PJ, Quattlebaum RG. Prevention of recurrent ischemic stroke. Am Fam Physician 2007; 76 (3): 382–8.
29. Millard MA, Hernandez-Vila EA. What Do the Guidelines Really Say About Aspirin? Texas Heart Institute J 2018; 45 (4): 228–9.
30. Arnett et al. ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease. 2019.
31. Антитромботическая терапия у больных со стабильными проявлениями атеротромбоза. Российские рекомендации. Кардиоваск. терапия и профилактика. 2009; 8 (Прил. 6): 20.
[Antitromboticheskaia terapiia u bol'nykh so stabil'nymi proiavleniiami aterotromboza. Rossiiskie rekomendatsii. Kardiovask. terapiia i profilaktika. 2009; 8 (Pril. 6): 20 (in Russian).]
32. Farrell B, Godwin J, Richards S, Warlow C. The United Kingdom transient ischaemic attack (UK-TIA) aspirin trial: final results. J Neurol Neurosurg Psychiatry 1991; 54 (12): 1044–54.
33. The Dutch TIA Trial Study Group. A comparison of two doses of aspirin (30 mg vs. 283 mg a day) in patients after a transient ischemic attack or minor ischemic stroke. N Engl J Med 1991; 325 (18): 1261–6.
34. The Canadian Cooperative Study Group. A randomized trial of aspirin and sulfinpyrazone in threatened stroke. N Engl J Med 1978; 299 (2): 53–9.
35. Johnson ES, Lanes SF, Wentworth CE III et al. A metaregression analysis of the dose-response effect of aspirin on stroke. Arch Intern Med 1999; 159 (11): 1248–53.
36. The SALT Collaborative Group. Swedish Aspirin Low-Dose Trial (SALT) of 75 mg aspirin as secondary prophylaxis after cerebrovascular ischaemic events. Lancet 1991; 338 (8779): 1345–9.
37. Drepper MD, Spahr L, Frossard JL. Clopidogrel and proton pump inhibitors – wh ere do we stand in 2012? World J Gastroenterol 2012; 18 (18): 2161–71.
38. Diener HC, Bogousslavsky J, Brass LM et al.; MATCH Investigators. Aspirin and clopidogrel compared with clopidogrel alone after recent ischaemic stroke or transient ischaemic attack in high-risk patients (MATCH): randomised, double-blind, placebo-controlled trial. Lancet 2004; 364 (9431): 331–7.
39. Lavie CJ, Howden CW, Scheiman J, Tursi J. Upper Gastrointestinal Toxicity Associated With Long-Term Aspirin Therapy: Consequences and Prevention. Curr Probl Cardiol 2017; 42: 146–64.
40. Namio Uemura, Kentaro Sugano, Hideyuki Hiraishi et al. Risk factor profiles, drug usage, and prevalence of aspirin-associated gastroduodenal injuries among high-risk cardiovascular Japanese patients: the results from the MAGIC study. J Gastroenterol 2014; 49: 814–24.
41. Van Hecken A, Juliano ML, Depre M et al. Effects of enteric-coated, low-dose aspirin on parameters of platelet function. Aliment Pharmacol Ther 2002; 16: 1683–8.
42. Mega JL, Close SL, Wiviott SD et al. Cytochrome p-450 polymorphisms and response to clopidogrel. N Engl J Med 2009; 360 (4): 354–62.
43. Nai-Fang Chi, Chi-Pang Wen, Chung-Hsiang Liu et al. Comparison Between Aspirin and Clopidogrel in Secondary Stroke Prevention Based on Real-World Data. J Am Heart Assoc 2018; 7: e009856.
44. Pezalla E, Day D, Pulliadath I. Initial assessment of clinical impact of a drug interaction between clopidogrel and proton pump inhibitors. J Am Coll Cardiol. 2008; 52(12): 1038–1039.
45. Wang Y, Pan Y, Zhao X et al.; CHANCE Investigators. Clopidogrel with aspirin in acute minor stroke or transient ischemic attack (CHANCE) trial: one-year outcomes. Circulation 2015; 132 (1): 40–6.
46. 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 (16): 1706–17.
47. The ESPS Group. The European Stroke Prevention Study (ESPS). Principal end-points. Lancet 1987; 2 (8572): 1351–4.
48. Diener HC, Cunha L, Forbes C et al. European Stroke Prevention Study. 2. Dipyridamole and acetylsalicylic acid in the secondary prevention of stroke. J Neurol Sci 1996; 143 (1–2): 1–13.
49. The Stroke Prevention in Reversible Ischemia Trial (SPIRIT) Study Group. A randomized trial of anticoagulants versus aspirin after cerebral ischemia of presumed arterial origin. Ann Neurol 1997; 42 (6): 857–65.
50. Halkes PH, van Gijn J, Kappelle LJ et al.; ESPRIT Study Group. Medium intensity oral anticoagulants versus aspirin after cerebral ischaemia of arterial origin (ESPRIT): a randomised controlled trial. Lancet Neurol 2007; 6 (2): 115–24.
51. Chimowitz MI, Lynn MJ, Howlett-Smith H et al.; Warfarin-Aspirin Symptomatic Intracranial Disease Trial Investigators. Comparison of warfarin and aspirin for symptomatic intracranial arterial stenosis. N Engl J Med 2005; 352 (13): 1305–16.
________________________________________________
2. Arsava EM, Kim GM, Oliveira-Filho J et al. Prediction of early recurrence after acute ischemic stroke. JAMA Neurol 2016; 73 (4): 396–401.
3. Mozaffarian D, Benjamin EJ, Go AS et al.; American Heart Association Statistics Committee; Stroke Statistics Subcommittee. Heart disease and stroke statistics-2016 update: a report fr om the American Heart Association. Circulation 2016; 133 (4): e38–e360.
4. Kernan WN, Ovbiagele B, Black HR et al.; American Heart Association Stroke Council, Council on Cardiovascular and Stroke Nursing, Council on Clinical Cardiology, and Council on Peripheral Vascular Disease. Guidelines for the prevention of stroke in patients with stroke and transient ischemic attack: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke 2014; 45 (7): 2160–236.
5. Oza R, Rundell K, Garcellano M. Recurrent Ischemic Stroke: Strategies for Preventio Am Fam Physician 2017; 96 (7): 436–40.
6. PATS Collaborating Group. Post-stroke antihypertensive treatment study. A preliminary result. Chin Med J (Engl) 1995; 108 (9): 710–7.
7. PROGRESS Collaborative Group. Randomised trial of a perindopril-based blood-pressure-lowering regimen among 6,105 individuals with previous stroke or transient ischaemic attack. Lancet 2001; 358 (9287): 1033–41.
8. James PA, Oparil S, Carter BL et al. 2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8). JAMA 2014; 311 (5): 507–20.
9. Stone NJ, Robinson JG, Lichtenstein AH et al.; 2013 ACC/AHA Cholesterol Guideline Panel. Treatment of blood cholesterol to reduce atherosclerotic cardiovascular disease risk in adults: synopsis of the 2013 American College of Cardiology/American Heart Association cholesterol guideline. Ann Intern Med 2014; 160 (5): 339–43.
10. Amarenco P, Bogousslavsky J, Callahan A III et al.; Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL) Investigators. High-dose atorvastatin after stroke or transient ischemic attack. N Engl J Med 2006; 355 (6): 549–59.
11. Naci H, Brugts JJ, Fleurence R, Ades AE. Comparative effects of statins on major cerebrovascular events: a multiple-treatments meta-analysis of placebo-controlled and active-comparator trials. QJM 2013; 106 (4): 299–306.
12. Karam JG, Loney-Hutchinson L, McFarlane SI. High-dose atorvastatin after stroke or transient ischemic attack: The Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL) Investigators. J Cardiometab Syndr 2008; 3 (1): 68–9.
13. Joseph JP, Afonso M, Berdaï D et al. Benefits and risks for primary prevention with statins in the elderly. Presse Med 2015; 44 (12 pt 1): 1219–25.
14. Kernan WN, Inzucchi SE, Sawan C et al. Obesity: a stubbornly obvious target for stroke prevention. Stroke 2013; 44 (1): 278–86.
15. Ruland S, Hung E, Richardson D et al.; African American Antiplatelet Stroke Prevention Study Investigators. Impact of obesity and the metabolic syndrome on risk factors in African American stroke survivors: a report from the AAASPS. Arch Neurol 2005; 62 (3): 386–90.
16. Ovbiagele B, Bath PM, Cotton D et al. Obesity and recurrent vascular risk after a recent ischemic stroke. Stroke 2011; 42 (12): 3397–402.
17. Doehner W, Schenkel J, Anker SD et al. Overweight and obesity are associated with improved survival, functional outcome, and stroke recurrence after acute stroke or transient ischaemic attack: observations from the TEMPiS trial. Eur Heart J 2013; 34 (4): 268–77.
18. Vemmos K, Ntaios G, Spengos K et al. Association between obesity and mortality after acute first-ever stroke: the obesity-stroke paradox. Stroke 2011; 42 (1): 30–6.
19. Epstein LJ, Kristo D, Strollo PJJr et al.; Adult Obstructive Sleep Apnea Task Force of the American Academy of Sleep Medicine. Clinical guideline for the evaluation, management and long-term care of obstructive sleep apnea in adults. J Clin Sleep Med 2009; 5 (3): 263–76.
20. Putaala J, Kurkinen M, Tarvos V et al. Silent brain infarcts and leukoaraiosis in young adults with first-ever ischemic stroke. Neurology 2009; 72 (21): 1823–9.
21. Mendis S, Abegunde D, Yusuf S et al. WHO study on prevention of recurrences of myocardial infarction and stroke (WHO-PREMISE). Bull World Health Organ 2005; 83 (11): 820–9.
22. Kaplan RC, Tirschwell DL, Longstreth WTJr et al. Vascular events, mortality, and preventive therapy following ischemic stroke in the elderly. Neurology 2005; 65 (6): 835–42.
23. Mostofsky E, Burger MR, Schlaug G et al. Alcohol and acute ischemic stroke onset: the stroke onset study. Stroke 2010; 41 (9): 1845–9.
24. MacKay-Lyons M, Gubitz G, Giacomantonio N et al. Program of rehabilitative exercise and education to avert vascular events after non-disabling stroke or transient ischemic attack (PREVENT Trial): a multi-centred, randomised controlled trial. BMC Neurol 2010; 10: 122.
25. Prior PL, Hachinski V, Unsworth K et al. Comprehensive cardiac rehabilitation for secondary prevention after transient ischemic attack or mild stroke: I: feasibility and risk factors. Stroke 2011; 42 (11): 3207–13.
26. Levin O.S., Bril' E.V. Pervichnaia i vtorichnaia profilaktika insul'ta. Sovremennaia terapiia v psikhiatrii i nevrologii. 2016; 1: 4–7 (in Russian).
27. Antithrombotic Trialists' Collaboration. Collaborative meta-analysis of randomised trials of antiplatelet therapy for prevention of death, myocardial infarction, and stroke in high risk patients. BMJ 2002; 324 (7329): 71–86.
28. Dickerson LM, Carek PJ, Quattlebaum RG. Prevention of recurrent ischemic stroke. Am Fam Physician 2007; 76 (3): 382–8.
29. Millard MA, Hernandez-Vila EA. What Do the Guidelines Really Say About Aspirin? Texas Heart Institute J 2018; 45 (4): 228–9.
30. Arnett et al. ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease. 2019.
31. Antitromboticheskaia terapiia u bol'nykh so stabil'nymi proiavleniiami aterotromboza. Rossiiskie rekomendatsii. Kardiovask. terapiia i profilaktika. 2009; 8 (Pril. 6): 20 (in Russian).
32. Farrell B, Godwin J, Richards S, Warlow C. The United Kingdom transient ischaemic attack (UK-TIA) aspirin trial: final results. J Neurol Neurosurg Psychiatry 1991; 54 (12): 1044–54.
33. The Dutch TIA Trial Study Group. A comparison of two doses of aspirin (30 mg vs. 283 mg a day) in patients after a transient ischemic attack or minor ischemic stroke. N Engl J Med 1991; 325 (18): 1261–6.
34. The Canadian Cooperative Study Group. A randomized trial of aspirin and sulfinpyrazone in threatened stroke. N Engl J Med 1978; 299 (2): 53–9.
35. Johnson ES, Lanes SF, Wentworth CE III et al. A metaregression analysis of the dose-response effect of aspirin on stroke. Arch Intern Med 1999; 159 (11): 1248–53.
36. The SALT Collaborative Group. Swedish Aspirin Low-Dose Trial (SALT) of 75 mg aspirin as secondary prophylaxis after cerebrovascular ischaemic events. Lancet 1991; 338 (8779): 1345–9.
37. Drepper MD, Spahr L, Frossard JL. Clopidogrel and proton pump inhibitors – wh ere do we stand in 2012? World J Gastroenterol 2012; 18 (18): 2161–71.
38. Diener HC, Bogousslavsky J, Brass LM et al.; MATCH Investigators. Aspirin and clopidogrel compared with clopidogrel alone after recent ischaemic stroke or transient ischaemic attack in high-risk patients (MATCH): randomised, double-blind, placebo-controlled trial. Lancet 2004; 364 (9431): 331–7.
39. Lavie CJ, Howden CW, Scheiman J, Tursi J. Upper Gastrointestinal Toxicity Associated With Long-Term Aspirin Therapy: Consequences and Prevention. Curr Probl Cardiol 2017; 42: 146–64.
40. Namio Uemura, Kentaro Sugano, Hideyuki Hiraishi et al. Risk factor profiles, drug usage, and prevalence of aspirin-associated gastroduodenal injuries among high-risk cardiovascular Japanese patients: the results from the MAGIC study. J Gastroenterol 2014; 49: 814–24.
41. Van Hecken A, Juliano ML, Depre M et al. Effects of enteric-coated, low-dose aspirin on parameters of platelet function. Aliment Pharmacol Ther 2002; 16: 1683–8.
42. Mega JL, Close SL, Wiviott SD et al. Cytochrome p-450 polymorphisms and response to clopidogrel. N Engl J Med 2009; 360 (4): 354–62.
43. Nai-Fang Chi, Chi-Pang Wen, Chung-Hsiang Liu et al. Comparison Between Aspirin and Clopidogrel in Secondary Stroke Prevention Based on Real-World Data. J Am Heart Assoc 2018; 7: e009856.
44. Pezalla E, Day D, Pulliadath I. Initial assessment of clinical impact of a drug interaction between clopidogrel and proton pump inhibitors. J Am Coll Cardiol. 2008; 52(12): 1038–1039.
45. Wang Y, Pan Y, Zhao X et al.; CHANCE Investigators. Clopidogrel with aspirin in acute minor stroke or transient ischemic attack (CHANCE) trial: one-year outcomes. Circulation 2015; 132 (1): 40–6.
46. 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 (16): 1706–17.
47. The ESPS Group. The European Stroke Prevention Study (ESPS). Principal end-points. Lancet 1987; 2 (8572): 1351–4.
48. Diener HC, Cunha L, Forbes C et al. European Stroke Prevention Study. 2. Dipyridamole and acetylsalicylic acid in the secondary prevention of stroke. J Neurol Sci 1996; 143 (1–2): 1–13.
49. The Stroke Prevention in Reversible Ischemia Trial (SPIRIT) Study Group. A randomized trial of anticoagulants versus aspirin after cerebral ischemia of presumed arterial origin. Ann Neurol 1997; 42 (6): 857–65.
50. Halkes PH, van Gijn J, Kappelle LJ et al.; ESPRIT Study Group. Medium intensity oral anticoagulants versus aspirin after cerebral ischaemia of arterial origin (ESPRIT): a randomised controlled trial. Lancet Neurol 2007; 6 (2): 115–24.
51. Chimowitz MI, Lynn MJ, Howlett-Smith H et al.; Warfarin-Aspirin Symptomatic Intracranial Disease Trial Investigators. Comparison of warfarin and aspirin for symptomatic intracranial arterial stenosis. N Engl J Med 2005; 352 (13): 1305–16.
Авторы
А.А. Пилипович
ФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова» Минздрава России (Сеченовский Университет), Москва, Россия
aapilipovich@mail.ru
Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
aapilipovich@mail.ru
ФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова» Минздрава России (Сеченовский Университет), Москва, Россия
aapilipovich@mail.ru
________________________________________________
Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
aapilipovich@mail.ru
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