Монотерапия тикагрелором как стратегия для снижения риска кровотечений у пациентов с острым коронарным синдромом, перенесших чрескожное коронарное вмешательство

Известно, что риск тромботических осложнений у пациентов с острым коронарным синдромом (ОКС) наиболее высок в первый год после события. Независимо от тактики лечения, в течение года после назначают двойную антиагрегантную терапию (ДААТ). ДААТ в значительной степени предотвращает тромботические осложнения, прежде всего повторный инфаркт миокарда. При этом закономерно повышается риск кровотечений. За последние годы получены убедительные данные, что переход от ДААТ на монотерапию тикагрелором через 1-3 мес. после события приводит к значительному снижению риска кровотечений без увеличения частоты тромботических осложнений по сравнению с ДААТ в течение 12 мес. В обзоре проанализированы данные рандомизированных клинических исследований по сравнению ДААТ и монотерапии тикагрелором у больных ОКС и представлены положения российских и международных клинических рекомендаций по лечению ОКА, касающиеся монотерапии тикагрелором.

Целью обзора является обоснование преимущества монотерапии тикагрелором по сравнению со стандартной ДААТ у пациентов с ОКС и чрескожным коронарным вмешательством с помощью детального анализа рандомизированных контролируемых исследований и метаанализов. В практической части приведены соответствующие разделы клинических рекомендаций.

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