russjcardiolРоссийский кардиологический журналRussian Journal of Cardiology1560-40712618-7620«SILICEA-POLIGRAF» LLC10.15829/1560-4071-2019-11-112-121russjcardiol-3565Research ArticleОБЗОРЫ ЛИТЕРАТУРЫREVIEWCовременная тактика лечения больных с ишемической болезнью сердца: принцип дополнительности в терапии и новые представления о ее роли и компонентахModern strategy of treating patients with coronary artery disease: complementarity principle in therapy and new ideas about its role and componentshttps://orcid.org/0000-0002-8505-1848ГиляревскийС. Р.GilyarevskiyS. R.

Гиляревский Сергей Руджерович — доктор медицинских наук, профессор кафедры  клинической фармакологии и  терапии.

Москва.

sgilarevsky@rambler.ruhttps://orcid.org/0000-0002-9865-4998ГолшмидМ. В.GolshmidM. V.

Кандидат медицинских наук,  доцент кафедры клинической фармакологии и терапии.

Москва.

sgilarevsky@rambler.ruhttps://orcid.org/0000-0001-9458-7305КузьминаИ. М.KuzminaI. M.

Кандидат медицинских наук,  руководитель  отделения  неотложной  кардиологии.

Москва.

sgilarevsky@rambler.ruРоссийская медицинская академия непрерывного профессионального образования Минздрава РоссииРоссияRussian Medical Academy of Continuing Professional EducationRussian FederationНИИ скорой помощи им. Н.В. Склифосовского, МоскваРоссияSklifosovsky Research Institute of Emergency MedicineRussian Federation201929102019011112121Copyright © Гиляревский С.Р., Голшмид М.В., Кузьмина И.М., 20192019Гиляревский С.Р., Голшмид М.В., Кузьмина И.М.Gilyarevskiy S.R., Golshmid M.V., Kuzmina I.M.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://russjcardiol.elpub.ru/jour/article/view/3565

В статье рассматриваются современные представления о роли механической реваскуляризации миокарда  и лекарственной  противоишемической  терапии в лечении  больных со  стабильным  течением  ишемической  болезни  сердца (ИБС).  Приводятся  современные данные  о  сравнительной   эффективности противоишемических препаратов, которые стали основанием для разработки концепции “бриллиантового подхода” к лечению больных со стабильным течением ИБС, которая предлагается вместо  стандартной  тактики с использованием иерархического  подхода  к выбору противоишемических  средств. Рассматриваются  особенности   применения   противоишемических   препаратов в определенных клинических ситуациях, у больных с наиболее распространенными сопутствующими заболеваниями или осложнениями  ИБС, а также при вариантах ИБС, в развитии которых играют роль специфические патофизиологические звенья.

The article discusses modern ideas about the role of mechanical revascularization and anti-ischemic  therapy  in the treatment of patients  with stable  coronary heart disease (CAD). Modern  data  on the  comparative  effectiveness  of anti-ischemic drugs  are  presented, which became the basis  for the development  of  “diamond approach”  in the treatment of stable CAD. It is proposed instead of standard tactics using a hierarchical approach to the choice of anti-ischemic drugs. The features  of the anti-ischemic  drugs use in certain clinical situations, in patients  with the most common comorbidities or complications  of CAD, as well as in CAD variants, in the development  of which specific pathophysiological elements  play a role, are considered.

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The authors declare that there are no conflicts of interest present.