В статье рассмотрены вопросы профилактики инсульта, в том числе повторного. Обсуждается выбор антикоагулянтной терапии у больных с фибрилляцией предсердий и рядом сопутствующих заболеваний – ишемической болезнью сердца, сахарным диабетом, хронической болезнью почек, хронической сердечной недостаточностью. Приведены данные субанализов рандомизированного клинического исследования ARISTOTLE, свидетельствующие о высоком профиле эффективности и безопасности нового орального антикоагулянта апиксабана у данных категорий больных.
In the article questions of prevention of stroke, including repeated ones, are considered. The choice of anticoagulant therapy is discussed in patients with atrial fibrillation and a number of concomitant diseases – coronary artery disease, diabetes mellitus, chronic kidney disease, chronic heart failure. The data of subanalyses of a randomized clinical trial of ARISTOTLE are presented, indicating a high profile of efficacy and safety of the new oral anticoagulant apixaban in these categories of patients.
1. O’DonnellMJ, XavierD, LiuL et al; INTERSTROKE investigators. Risk factors for ischaemic and intracerebral haemorrhagic stroke in 22 countries (the INTERSTROKE study): a case-control study. Lancet 2010: 376; 112–23. DOI: 10.1016/S0140-6736(10)60834-3
2. Mancia G, Fagard R, Narkiewicz K et al. 2013 ESH/ESC Guidelines for the management of arterial hypertension. The Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Hypertens J 2013; 31: 1281–357. DOI: 10.1093/eurheartj/eht151
3. Диагностика и лечение артериальной гипертонии: клинические рекомендации. Кардиологический вестн. 2015; X (1): 3–30. / Diagnostika i lechenie arterialnoi gipertonii: klinicheskie rekomendatsii. Kardiologicheskii vestn. 2015; X (1): 3–30. [in Russian]
4. Kirchhof P, Benussi S, Kotecha D et al 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS. Eur Heart J 2016; 37 (38): 2893–962. DOI: 10.1093/ejcts/ezw313
5. Stewart S, Hart CL, Hole DJ, McMurray JJ. Population prevalence, incidence, and predictors of atrial fibrillation in the Renfrew/Paisley study. Heart 2001; 86: 516–21. DOI: 10.1136/heart.86.5.516
6. Go AS, Hylek EM, Phillips KA et al. Prevalence of diagnosed atrial fibrillation in adults: national implications for rhythm management and stroke prevention: the AnTicoagulation and Risk Factors in Atrial Fibrillation (ATRIA) Study. JAMA 2001; 285: 2370–5.
7. Miyasaka Y, Barnes ME, Gersh BJ et al. Secular trends in incidence of atrial fibrillation in Olmsted County, Minnesota, 1980 to 2000, and implications on the projections for future prevalence. Circulation 2006; 114: 119–125. DOI: 10.1161/CIRCULATIONAHA.105.595140
8. Heeringa J, van der Kuip DA, Hofman A et al. Prevalence, incidence and lifetime risk of atrial fibrillation: the Rotterdam study. Eur Heart J 2006; 27: 949–53. DOI: 10.1093/eurheartj/ehi825
9. Naccarelli GV, Varker H, Lin J, Schulman KL. Increasing prevalence of atrial fibrillation and flutter in the United States. Am J Cardiol 2009; 104: 1534–9. DOI: 10.1016/j.amjcard.2009.07.022
10. Lloyd‐Jones DM, Wang TJ, Leip EP et al. Lifetime risk for development of atrial fibrillation: the Framingham Heart Study. Circulation 2004; 110: 1042–6. DOI: 10.1161/01.CIR.0000140263.20897.42
11. Рубаненко О.А. Коморбидная патология у пациентов с фибрилляцией предсердий. Известия Самарского научного центра РАН. 2015; 17 (2): 367–70. / Rubanenko O.A. Komorbidnaia patologiia u patsientov s fibrilliatsiei predserdii. Izvestiia Samarskogo nauchnogo tsentra RAN. 2015; 17 (2): 367–70. [in Russian]
12. Lip GY, Laroche C, Dan GA et al. A prospective survey in European Society of Cardiology member countries of atrial fibrillation management: baseline results of EURObservational Research Programme Atrial Fibrillation (EORP-AF) Pilot General Registry. Europace 2014; 16 (3): 308–19. DOI: 10.1093/europace/eut373
13. Dorian P, Guerra PG, Kerr CR et al. Validation of a new simple scale to measure symptoms in atrial fibrillation: the Canadian Cardiovascular Society Severity in Atrial Fibrillation scale. Circ Arrhythm Electrophysiol 2009; 2: 218–24. DOI: 10.1161/CIRCEP.108.812347
14. Cho JR, Angiolillo DJ. Percutaneous coronary intervention and atrial fibrillation: The triple therapy dilemma. J Thromb Thrombolysis 2015; 39: 203–8. DOI: 10.1007/s11239-014-1132-z
15. Valgimigli M, Bueno H, Byrne RA et al; ESC Scientific Document Group; ESC Committee for Practice Guidelines (CPG); ESC National Cardiac Societies. 2017 ESC focused update on dual antiplatelet therapy in coronary artery disease developed in collaboration with EACTS: The Task Force for dual antiplatelet therapy in coronary artery disease of the European Society of Cardiology (ESC) and of the European Association for Cardio-Thoracic Surgery (EACTS). Eur Heart J 2018; 39 (3): 213–60. DOI: 10.1093/eurheartj/ehx419
16. Bahit MC, Lopes RD, Wojdyla DM et al. Apixaban in patients with atrial fibrillation and prior coronary artery disease: Insights from the ARISTOTLE trial. Int J Cardiol 2013; 170: 215–20. DOI: 10.1016/j.ijcard.2013.10.062
17. Benjamin EJ, Levy D, Vaziri SM et al. Independent risk factors for atrial fibrillation in a population-based cohort. The Framingham Heart Study. JAMA 1994; 271 (11): 840–4.
18. Furberg C, Psaty B, Monolio T et al. The CHS Collaborative Research Group Prevalence of atrial fibrillation in elderly subjects (the Cardiovascular Health Study). Am J Cardiol 1994; 74 (3): 236–41. DOI: https://doi.org/10.1016/0002-9149(94)90363-8
19. Cleland JG, Chattopadhyay S, Khand A et al. Prevalence and incidence of arrhythmias and sudden death in heart failure. Heart Fail Rev 2002; 7 (3): 229–42.
20. Dries D, Exner D, Gersh BJ et al. Atrial fibrillation is associated with an increased risk for mortality and heart failure progression in patients with asymptomatic and symptomatic left ventricular systolic dysfunction: a retrospective analysis of the SOLVD trials. Am Coll Cardiol 1998; 32 (3): 695–703. https://doi.org/10.1016/S0735-1097(98)00297-6
21. Cleland JGF, Swedberg K, Follath F et al, for the Study Group on Diagnosis of the Working Group on Heart Failure of the European Society of Cardiology. The Euro Heart Failure survey programme – a survey on the quality of care among patients with heart failure in Europe. Part 1: patient characteristics and diagnosis. Eur Heart J 2003; 24: 442–63.
22. McMurray JJV, Ezekowitz JA, Lewis BS et al; ARISTOTLE Committees and Investigators.et al. Left ventricular systolic dysfunction, heart failure, and the risk of stroke and systemic embolism in patients with atrial fibrillation insights from the ARISTOTLE trial. Circ Heart Fail 2013; 6 (3): 451–60. DOI: 10.1161/CIRCHEARTFAILURE.112.000143
23. Ezekowitz JA, Lewis BS, Lopes RD et al. Clinical outcomes of patients with diabetes and atrial fibrillation treated with apixaban: results from the ARISTOTLE trial. Eur Heart J Cardiovasc Pharmacother 2015; 1 (2): 86–94. DOI: 10.1093/ehjcvp/pvu024
24. Grand’Maison A, Charest AF, Geerts WH. Anticoagulant use in patients with chronic renal impairment. Am J Cardiovasc Drugs 2005; 5 (5): 291–305.
25. Go AS, Fang MC, Udaltsova N et al; ATRIA Study Investigators.et al. Impact of proteinuria and glomerular filtration rate on risk of thromboembolism in atrial fibrillation: the anticoagulation and risk factors in atrial fibrillation (ATRIA) study. Circulation 2009; 119 (10): 1363–9. DOI: 10.1161/CIRCULATIONAHA.108.816082
26. Herzog CA, Asinger RW, Berger AK et al. Cardiovascular disease in chronic kidney disease. A clinical update from Kidney Disease: Improving Global Outcomes (KDIGO). Kidney Int 2011; 80 (6): 572–86. DOI: 10.1038/ki.2011.223
27. Hohnloser SH, Hijazi Z, Thomas L et al. Efficacy of apixaban when compared with warfarin in relation to renal function in patients with atrial fibrillation: insights from the ARISTOTLE trial. Eur Heart J 2012; 33 (22): 2821–830. DOI: 10.1093/eurheartj/ehs274
28. Soliman EZ, Prineas RJ, Go AS et al; Chronic Renal Insufficiency Cohort (CRIC) Study Group. Chronic kidney disease and prevalent atrial fibrillation: the Chronic Renal Insufficiency Cohort (CRIC). Am Heart J 2010; 159 (6): 1102–7. DOI: 10.1016/j.ahj.2010.03.027
29. Hijazi Z, Hohnloser SH, Andersson U et al. Efficacy and Safety of Apixaban Compared With Warfarin in Patients With Atrial Fibrillation in Relation to Renal Function Over Time: Insights From the ARISTOTLE Randomized Clinical Trial. JAMA Cardiol 2016; 1 (4): 451–60. DOI: 10.1001/jamacardio.2016.1170
30. Dhamoon MS, Tai W, Boden-Albala B et al. Risk of myocardial infarction or vascular death after first ischemic stroke: The Northern Manhattan Study. Stroke 2007; 38: 1752–8. DOI: 10.1161/STROKEAHA.106.480988
31. Carter AM, Catto AJ, Mansfield MW et al. Predictive variables for mortality after acute ischemic stroke. Stroke 2007; 38: 1873–80. DOI: 10.1161/STROKEAHA.106.474569
32. Weimar Ch, Benemann J, Michalski D et al; German Stroke Study Collaboration.. Prediction of recurrent stroke and vascular death in patients with transient ischemic attack or nondisabling stroke. Stroke 2010; 41: 487–93. DOI: 10.1161/STROKEAHA.109.562157
33. Sacco RL, Adams R, Albers G et al; American Heart Association; American Stroke Association Council on Stroke; Council on Cardiovascular Radiology and Intervention; American Academy of Neurology. Guidelines for Prevention of Stroke in Patients With Ischemic Stroke or Transient Ischemic Attack: A Statement for Healthcare Professionals From the American Heart Association/American Stroke Association Council on Stroke: Co-Sponsored by the Council on Cardiovascular Radiology and Intervention: The American Academy of Neurology affirms the value of this guideline. Stroke 2006; 37: 577–617. DOI: 10.1161/01.STR.0000199147.30016.74
34. European Stroke Organisation (ESO) Executive Committee; ESO Writing Committee. Guidelines for management of ischaemic stroke and transient ischaemic attack. Cerebrovasc Dis 2008; 25: 457–507. DOI: 10.1159/000131083
35. Furie KL, Kasner SE, Adams RJ et al; American Heart Association Stroke Council, Council on Cardiovascular Nursing, Council on Clinical Cardiology, and Interdisciplinary Council on Quality of Care and Outcomes Research. Guidelines for the Prevention of Stroke in Patients With Stroke or Transient Ischemic Attack A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association. Stroke 2011; 42: 227–76. DOI: 10.1161/STR.0b013e3181f7d043
36. Easton JD, Lopes RD, Bahit MC et al; ARISTOTLE Committees and Investigators. Apixaban compared with warfarin in patients with atrial fibrillation and previous stroke or transient ischaemic attack: a subgroup analysis of the ARISTOTLE trial. Lancet Neurol 2012; 11 (6): 503–11. DOI: 10.1016/S1474-4422(12)70092-3
37. Lopes RD, Shah BR, Olson DM et al. Antithrombotic therapy use at discharge and 1 year in patients with atrial fibrillation and acute stroke: Results from the AVAIL registry. Stroke 2011; 42 (12): 3477–83. DOI: 10.1161/STROKEAHA.111.625392
38. Go AS, Hylek EM, Borowsky LH et al. Warfarin use among ambulatory patients with nonvalvular atrial fibrillation: the anticoagulation and risk factors in atrial fibrillation (ATRIA) study. Ann Intern Med 1999; 131 (12): 927–34.
________________________________________________
1. O’DonnellMJ, XavierD, LiuL et al; INTERSTROKE investigators. Risk factors for ischaemic and intracerebral haemorrhagic stroke in 22 countries (the INTERSTROKE study): a case-control study. Lancet 2010: 376; 112–23. DOI: 10.1016/S0140-6736(10)60834-3
2. Mancia G, Fagard R, Narkiewicz K et al. 2013 ESH/ESC Guidelines for the management of arterial hypertension. The Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Hypertens J 2013; 31: 1281–357. DOI: 10.1093/eurheartj/eht151
3. Diagnostika i lechenie arterialnoi gipertonii: klinicheskie rekomendatsii. Kardiologicheskii vestn. 2015; X (1): 3–30. [in Russian]
4. Kirchhof P, Benussi S, Kotecha D et al 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS. Eur Heart J 2016; 37 (38): 2893–962. DOI: 10.1093/ejcts/ezw313
5. Stewart S, Hart CL, Hole DJ, McMurray JJ. Population prevalence, incidence, and predictors of atrial fibrillation in the Renfrew/Paisley study. Heart 2001; 86: 516–21. DOI: 10.1136/heart.86.5.516
6. Go AS, Hylek EM, Phillips KA et al. Prevalence of diagnosed atrial fibrillation in adults: national implications for rhythm management and stroke prevention: the AnTicoagulation and Risk Factors in Atrial Fibrillation (ATRIA) Study. JAMA 2001; 285: 2370–5.
7. Miyasaka Y, Barnes ME, Gersh BJ et al. Secular trends in incidence of atrial fibrillation in Olmsted County, Minnesota, 1980 to 2000, and implications on the projections for future prevalence. Circulation 2006; 114: 119–125. DOI: 10.1161/CIRCULATIONAHA.105.595140
8. Heeringa J, van der Kuip DA, Hofman A et al. Prevalence, incidence and lifetime risk of atrial fibrillation: the Rotterdam study. Eur Heart J 2006; 27: 949–53. DOI: 10.1093/eurheartj/ehi825
9. Naccarelli GV, Varker H, Lin J, Schulman KL. Increasing prevalence of atrial fibrillation and flutter in the United States. Am J Cardiol 2009; 104: 1534–9. DOI: 10.1016/j.amjcard.2009.07.022
10. Lloyd‐Jones DM, Wang TJ, Leip EP et al. Lifetime risk for development of atrial fibrillation: the Framingham Heart Study. Circulation 2004; 110: 1042–6. DOI: 10.1161/01.CIR.0000140263.20897.42
11. Rubanenko O.A. Komorbidnaia patologiia u patsientov s fibrilliatsiei predserdii. Izvestiia Samarskogo nauchnogo tsentra RAN. 2015; 17 (2): 367–70. [in Russian]
12. Lip GY, Laroche C, Dan GA et al. A prospective survey in European Society of Cardiology member countries of atrial fibrillation management: baseline results of EURObservational Research Programme Atrial Fibrillation (EORP-AF) Pilot General Registry. Europace 2014; 16 (3): 308–19. DOI: 10.1093/europace/eut373
13. Dorian P, Guerra PG, Kerr CR et al. Validation of a new simple scale to measure symptoms in atrial fibrillation: the Canadian Cardiovascular Society Severity in Atrial Fibrillation scale. Circ Arrhythm Electrophysiol 2009; 2: 218–24. DOI: 10.1161/CIRCEP.108.812347
14. Cho JR, Angiolillo DJ. Percutaneous coronary intervention and atrial fibrillation: The triple therapy dilemma. J Thromb Thrombolysis 2015; 39: 203–8. DOI: 10.1007/s11239-014-1132-z
15. Valgimigli M, Bueno H, Byrne RA et al; ESC Scientific Document Group; ESC Committee for Practice Guidelines (CPG); ESC National Cardiac Societies. 2017 ESC focused update on dual antiplatelet therapy in coronary artery disease developed in collaboration with EACTS: The Task Force for dual antiplatelet therapy in coronary artery disease of the European Society of Cardiology (ESC) and of the European Association for Cardio-Thoracic Surgery (EACTS). Eur Heart J 2018; 39 (3): 213–60. DOI: 10.1093/eurheartj/ehx419
16. Bahit MC, Lopes RD, Wojdyla DM et al. Apixaban in patients with atrial fibrillation and prior coronary artery disease: Insights from the ARISTOTLE trial. Int J Cardiol 2013; 170: 215–20. DOI: 10.1016/j.ijcard.2013.10.062
17. Benjamin EJ, Levy D, Vaziri SM et al. Independent risk factors for atrial fibrillation in a population-based cohort. The Framingham Heart Study. JAMA 1994; 271 (11): 840–4.
18. Furberg C, Psaty B, Monolio T et al. The CHS Collaborative Research Group Prevalence of atrial fibrillation in elderly subjects (the Cardiovascular Health Study). Am J Cardiol 1994; 74 (3): 236–41. DOI: https://doi.org/10.1016/0002-9149(94)90363-8
19. Cleland JG, Chattopadhyay S, Khand A et al. Prevalence and incidence of arrhythmias and sudden death in heart failure. Heart Fail Rev 2002; 7 (3): 229–42.
20. Dries D, Exner D, Gersh BJ et al. Atrial fibrillation is associated with an increased risk for mortality and heart failure progression in patients with asymptomatic and symptomatic left ventricular systolic dysfunction: a retrospective analysis of the SOLVD trials. Am Coll Cardiol 1998; 32 (3): 695–703. https://doi.org/10.1016/S0735-1097(98)00297-6
21. Cleland JGF, Swedberg K, Follath F et al, for the Study Group on Diagnosis of the Working Group on Heart Failure of the European Society of Cardiology. The Euro Heart Failure survey programme – a survey on the quality of care among patients with heart failure in Europe. Part 1: patient characteristics and diagnosis. Eur Heart J 2003; 24: 442–63.
22. McMurray JJV, Ezekowitz JA, Lewis BS et al; ARISTOTLE Committees and Investigators.et al. Left ventricular systolic dysfunction, heart failure, and the risk of stroke and systemic embolism in patients with atrial fibrillation insights from the ARISTOTLE trial. Circ Heart Fail 2013; 6 (3): 451–60. DOI: 10.1161/CIRCHEARTFAILURE.112.000143
23. Ezekowitz JA, Lewis BS, Lopes RD et al. Clinical outcomes of patients with diabetes and atrial fibrillation treated with apixaban: results from the ARISTOTLE trial. Eur Heart J Cardiovasc Pharmacother 2015; 1 (2): 86–94. DOI: 10.1093/ehjcvp/pvu024
24. Grand’Maison A, Charest AF, Geerts WH. Anticoagulant use in patients with chronic renal impairment. Am J Cardiovasc Drugs 2005; 5 (5): 291–305.
25. Go AS, Fang MC, Udaltsova N et al; ATRIA Study Investigators.et al. Impact of proteinuria and glomerular filtration rate on risk of thromboembolism in atrial fibrillation: the anticoagulation and risk factors in atrial fibrillation (ATRIA) study. Circulation 2009; 119 (10): 1363–9. DOI: 10.1161/CIRCULATIONAHA.108.816082
26. Herzog CA, Asinger RW, Berger AK et al. Cardiovascular disease in chronic kidney disease. A clinical update from Kidney Disease: Improving Global Outcomes (KDIGO). Kidney Int 2011; 80 (6): 572–86. DOI: 10.1038/ki.2011.223
27. Hohnloser SH, Hijazi Z, Thomas L et al. Efficacy of apixaban when compared with warfarin in relation to renal function in patients with atrial fibrillation: insights from the ARISTOTLE trial. Eur Heart J 2012; 33 (22): 2821–830. DOI: 10.1093/eurheartj/ehs274
28. Soliman EZ, Prineas RJ, Go AS et al; Chronic Renal Insufficiency Cohort (CRIC) Study Group. Chronic kidney disease and prevalent atrial fibrillation: the Chronic Renal Insufficiency Cohort (CRIC). Am Heart J 2010; 159 (6): 1102–7. DOI: 10.1016/j.ahj.2010.03.027
29. Hijazi Z, Hohnloser SH, Andersson U et al. Efficacy and Safety of Apixaban Compared With Warfarin in Patients With Atrial Fibrillation in Relation to Renal Function Over Time: Insights From the ARISTOTLE Randomized Clinical Trial. JAMA Cardiol 2016; 1 (4): 451–60. DOI: 10.1001/jamacardio.2016.1170
30. Dhamoon MS, Tai W, Boden-Albala B et al. Risk of myocardial infarction or vascular death after first ischemic stroke: The Northern Manhattan Study. Stroke 2007; 38: 1752–8. DOI: 10.1161/STROKEAHA.106.480988
31. Carter AM, Catto AJ, Mansfield MW et al. Predictive variables for mortality after acute ischemic stroke. Stroke 2007; 38: 1873–80. DOI: 10.1161/STROKEAHA.106.474569
32. Weimar Ch, Benemann J, Michalski D et al; German Stroke Study Collaboration.. Prediction of recurrent stroke and vascular death in patients with transient ischemic attack or nondisabling stroke. Stroke 2010; 41: 487–93. DOI: 10.1161/STROKEAHA.109.562157
33. Sacco RL, Adams R, Albers G et al; American Heart Association; American Stroke Association Council on Stroke; Council on Cardiovascular Radiology and Intervention; American Academy of Neurology. Guidelines for Prevention of Stroke in Patients With Ischemic Stroke or Transient Ischemic Attack: A Statement for Healthcare Professionals From the American Heart Association/American Stroke Association Council on Stroke: Co-Sponsored by the Council on Cardiovascular Radiology and Intervention: The American Academy of Neurology affirms the value of this guideline. Stroke 2006; 37: 577–617. DOI: 10.1161/01.STR.0000199147.30016.74
34. European Stroke Organisation (ESO) Executive Committee; ESO Writing Committee. Guidelines for management of ischaemic stroke and transient ischaemic attack. Cerebrovasc Dis 2008; 25: 457–507. DOI: 10.1159/000131083
35. Furie KL, Kasner SE, Adams RJ et al; American Heart Association Stroke Council, Council on Cardiovascular Nursing, Council on Clinical Cardiology, and Interdisciplinary Council on Quality of Care and Outcomes Research. Guidelines for the Prevention of Stroke in Patients With Stroke or Transient Ischemic Attack A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association. Stroke 2011; 42: 227–76. DOI: 10.1161/STR.0b013e3181f7d043
36. Easton JD, Lopes RD, Bahit MC et al; ARISTOTLE Committees and Investigators. Apixaban compared with warfarin in patients with atrial fibrillation and previous stroke or transient ischaemic attack: a subgroup analysis of the ARISTOTLE trial. Lancet Neurol 2012; 11 (6): 503–11. DOI: 10.1016/S1474-4422(12)70092-3
37. Lopes RD, Shah BR, Olson DM et al. Antithrombotic therapy use at discharge and 1 year in patients with atrial fibrillation and acute stroke: Results from the AVAIL registry. Stroke 2011; 42 (12): 3477–83. DOI: 10.1161/STROKEAHA.111.625392
38. Go AS, Hylek EM, Borowsky LH et al. Warfarin use among ambulatory patients with nonvalvular atrial fibrillation: the anticoagulation and risk factors in atrial fibrillation (ATRIA) study. Ann Intern Med 1999; 131 (12): 927–34.
1 ФГБОУ ВО «Московский государственный медико-стоматологический университет им. А.И.Евдокимова» Минздрава России. 127473, Россия, Москва, ул. Делегатская, д. 20, стр. 1;
2 ФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М.Сеченова» Минздрава России. 119991, Россия, Москва, ул. Трубецкая, д. 8, стр. 2;
3 ГБУЗ «Городская клиническая больница им. Е.О.Мухина» Департамента здравоохранения г. Москвы. 111399, Россия, Москва, Федеративный пр-т, д. 17 *ostroumova.olga@mail.ru
1 A.I.Evdokimov Moscow State University of Medicine and Dentistry of the Ministry of Health of the Russian Federation. 127473, Russian Federation, Moscow, ul. Delegatskaia, d. 20, str. 1;
2 I.M.Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation. 119991, Russian Federation, Moscow, ul. Trubetskaya, d. 8, str. 2;
3 E.O.Muhin City Clinical Hospital of the Department of Health of Moscow. 111399, Russian Federation, Moscow, Federativnyi pr-t, d. 17 *ostroumova.olga@mail.ru