ОСТРЫЙ КОРОНАРНЫЙ СИНДРОМ У ПАЦИЕНТОВ СО ЗЛОКАЧЕСТВЕННЫМИ НОВООБРАЗОВАНИЯМИ
https://doi.org/10.15829/1560-4071-2017-3-140-144
Аннотация
Острый коронарный синдром (ОКС) в разные сроки с момента выявления онкологического заболевания развивается у 1,9-4,2% пациентов, причем нередко в интактных коронарных артериях. В структуре ОКС значительно преобладает ОКС без подъема сегмента ST (>85%). Специфическими факторами риска развития ОКС является тромбоцитопения, в т.ч. возникшая после проведения химиотерапии, а также лучевая терапия. Пациенты с активным онкологическим процессом имеют более высокий риск смерти при лечении ОКС, чем пациенты с “излеченным” ранее заболеванием. Тактика ведения ОКС на фоне онкологических заболеваний остается за границами современных рекомендаций, т.к. подобные пациенты не включались в рандомизированные клинические исследования. Вместе с тем в некоторых исследованиях авторами показана эффективность приема ацетилсалициловой кислоты, двойной антитромбоцитарной терапии, выполнения чрескожных коронарных вмешательств. Однако изменения в системе гемостаза, кардиотоксичность противоопухолевого лечения, риски лучевой терапии обуславливают необходимость мультидисциплинарного подхода к ведению ОКС у пациентов этой группы.
Ключевые слова
Об авторах
Е. С. Лубоятникова
Самарский государственный медицинский университет
Россия
Россия
Ординатор кафедры кардиологии и сердечно-сосудистой хирургии ИПО
Д. В. Дупляков
Самарский государственный медицинский университет; Самарский областной клинический кардиологический диспансер
Россия
Россия
Доктор медицинских наук, заместитель главного врача Самарского областного клинического кардиологического диспансера, профессор кафедры кардиологии и сердечно-сосудистой хирургии ИПО
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Рецензия
Для цитирования:
Лубоятникова Е.С., Дупляков Д.В. ОСТРЫЙ КОРОНАРНЫЙ СИНДРОМ У ПАЦИЕНТОВ СО ЗЛОКАЧЕСТВЕННЫМИ НОВООБРАЗОВАНИЯМИ. Российский кардиологический журнал. 2017;(3):140-144. https://doi.org/10.15829/1560-4071-2017-3-140-144
For citation:
Luboyatnikova E.S., Duplyakov D.V. ACUTE CORONARY SYNDROME IN MALIGNANCY PATIENTS. Russian Journal of Cardiology. 2017;(3):140-144. (In Russ.) https://doi.org/10.15829/1560-4071-2017-3-140-144
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