russjcardiolРоссийский кардиологический журналRussian Journal of Cardiology1560-40712618-7620«SILICEA-POLIGRAF» LLC10.15829/1560-4071-2020-3812russjcardiol-3812Research ArticleОБЗОРЫ ЛИТЕРАТУРЫREVIEWСроки назначения двойной антитромбоцитарной терапии при остром коронарном синдроме: проблема доступности коронарного шунтирования для пациентовTiming of dual antiplatelet therapy in acute coronary syndrome: a problem of coronary artery bypass grafting accessibility for patientshttps://orcid.org/0000-0002-9007-9108ГоловинаТ. С.GolovinaT. S.

к.м.н., врач кардиолог кардиохирургического отделения

Кемерово

Kemerovo

tanya-golovina-1976@mail.ruhttps://orcid.org/0000-0001-7016-0518НевероваЮ. Н.NeverovaYu. N.

к.м.н., врач сердечно-сосудистый хирург кардиохирургического отделения, м. н.с. лаборатории реконструктивной хирургии мультифокального атеросклероза

Кемерово

Kemerovo

yuli4cka.n@yandex.ruhttps://orcid.org/0000-0003-3882-709XТарасовР. C.TarasovR. S.

д.м.н., зав. лабораторией реконструктивной хирургии мультифокального атеросклероза

Кемерово

Kemerovo

roman.tarasov@mail.ruФГБНУ Научно-исследовательский институт комплексных проблем сердечно-сосудистых заболеванийРоссияResearch Institute for Complex Issues of Cardiovascular DiseasesRussian Federation20202105202025838123812Copyright © Головина Т.С., Неверова Ю.Н., Тарасов Р.C., 20202020Головина Т.С., Неверова Ю.Н., Тарасов Р.C.Golovina T.S., Neverova Y.N., Tarasov R.S.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/3812

Целесообразность максимально раннего назначения двойной антитромбоцитарной терапии в группе пациентов с острым коронарным синдромом с подъемом сегмента ST, где доминирующей стратегией лечения является чрескожное коронарное вмешательство, определено и доказано: оно улучшает результаты лечения посредством снижения рисков неблагоприятных ишемических событий, включая тромбоз стента и инфаркт миокарда.В настоящей статье приводится детальный анализ доказательной базы и актуальных рекомендаций по обоснованности и срокам назначения двойной антитромбоцитарной терапии при различных формах острого коронарного синдрома. Делается акцент на противоречиях, касающихся раннего назначения двойной антитромбоцитарной терапии при остром коронарном синдроме без подъема сегмента ST. Приводится обоснование назначения двойной антитромбоцитарной терапии при данной патологии только после выполнения коронарографии и определения стратегии реваскуляризации, что должно увеличить доступность операции коронарного шунтирования для пациентов.

The feasibility of dual antiplatelet therapy as early as possible in patients with ST-segment elevation acute coronary syndrome, where percutaneous coronary intervention is recommended, has been proven: it improves treatment outcomes by reducing the risk of adverse ischemic events, including stent thrombosis and myocardial infarction.This article provides a detailed analysis of the evidence data and current recommendations on the validity and timing of dual antiplatelet therapy for acute coronary syndrome. The emphasis is made on the controversy regarding the early dual antiplatelet therapy in non-ST-segment elevation acute coronary syndrome. The rationale for using dual antiplatelet therapy only after coronary angiography and determining the revascularization strategy is described, which should increase the accessibility of coronary artery bypass graft surgery for patients.

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