АНТИАГРЕГАНТНАЯ ТЕРАПИЯ ОСТРОГО КОРОНАРНОГО СИНДРОМА : СОВРЕМЕННЫЕ ВОЗМОЖНОСТИ

Двойная антиагрегантная терапия (ацетилсалициловая кислота и блокатор P2Y12-рецепторов тромбоцитов) — стандартный компонент лечения любого типа острого коронарного синдрома, независимо от проведения реперфузии и выбранной лечебной стратегии. В связи с определенными ограничениями в применении клопидогрела в качестве 2-го компонента двойной антиагрегантной терапии у пациентов с острым коронарным синдромом с выполненным чрескожным коронарным вмешательством прежде всего должна быть рассмотрена возможность назначения прасугрела или тикагрелора. Их эффективность, превосходящая эффективность клопидогрела, была доказана в крупных клинических исследованиях, по результатам которых прасугрел и тикагрелор были включены во все основные международные и российские рекомендации по лечению этой категории больных с одинаковым классом и уровнем доказанности. В настоящее время нет данных какого-либо завершившегося крупного рандомизированного клинического исследования достаточной статистической мощности, которое напрямую сравнивало бы эффективность и безопасность прасугрела и тикагрелора, поэтому необходим тщательный анализ всех накопленных по каждому препарату данных о его эффективности и безопасности, включая результаты метаанализов и регистров, для оказания лучшей помощи каждому конкретному пациенту.

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