References

emcardio

Неотложная кардиология и кардиоваскулярные риски

Emergency Cardiology and Cardiovascular Risks journal

2616-633X

Белорусский государственный медицинский университет

emcardio-240

Research Article

Мастер-класс

Master-class

Сложные вопросы антитромботической терапии при остром коронарном синдроме у пациентов с фибрилляцией предсердий

Complex problems of antithrombotic therapy for acute coronary syndrome in patients with atrial fibrillation

Рудой

А. С.

Rudoy

A. S.

andrewrudoj@gmai.com

Лысый

Ю. С.

Lysyy

Yu. S.

lysyyju@rambler.ru

Белорусский государственный медицинский университетBelarusГУ «432 ордена Красной Звезды главный военный клинический медицинский центр Вооруженных Сил Республики Беларусь»Belarus

2019

12112025

474–488

2025

Рудой А.С., Лысый Ю.С.

Rudoy A.S., Lysyy Y.S.

Данная работа распространяется под лицензией Creative Commons Attribution 4.0.

This work is licensed under a Creative Commons Attribution 4.0 License.

https://emcardio.bsmu.by/jour/article/view/240

Вопросы выбора антикоагулянта, количества антиагрегантов и длительности антитромботической терапии у пациентов с острым коронарным синдромом, имеющим показания к приему оральных антикоагулянтов, в частности при фибрилляции предсердий, остаются сложными и неоднозначными. С одной стороны, развитие острого коронарного синдрома требует назначения двойной антиагрегантной терапии, с другой, совместный прием антикоагулянта и антиагрегантов значительно повышает геморрагические риски. Складывается клиническая ситуация, когда необходимы четкие знания в стратегии и выборе антитромботических препаратов – соблюдении баланса между риском развития тромбоза стента, тромбоэмболическими и геморрагическими осложнениями. В представленном обзоре систематизированы данные, касающиеся режима антитромботической терапии, при различных видах острого коронарного синдрома у пациентов с фибрилляцией предсердий в зависимости от выбора тактики лечения (фармако-инвазивной, либо консервативной).

The choice of anticoagulant, the number of antiplatelet agents and the duration of antithrombotic therapy in patients with acute coronary syndrome with indications for oral anticoagulants, in particular for atrial fibrillation, remain complex and ambiguous. On the one hand, the development of acute coronary syndrome requires the appointment of dual antiplatelet therapy, on the other, the combined use of anticoagulant and antiaggregants significantly increases hemorrhagic risks. There is a clinical situation, when you need a clear knowledge of the strategy and choice of antithrombotic drugs, in particular the knowledge about the balance between the risk of developing stent thrombosis, thromboembolic and hemorrhagic complications. In the presented review, the data concerning the regime of antithrombotic therapy are systematized in various types of acute coronary syndrome in patients with atrial fibrillation, depending on the choice of treatment tactics (pharmaco-invasive or conservative).

острый коронарный синдром (ОКС)фибрилляции предсердийантиагрегантыновые пероральные антикоагулянтыне являющиеся антагонистами витамина К (НОАК)двойная антитромбоцитарная терапия (ДАТТ)ишемические событиякровотечениячрезкожное коронарное вмешательство (ЧКВ)

acute coronary syndrome (ACS)atrial fibrillationantiplatelet agentsoral anticoagulantsnon-vitamin K antagonist oral anticoagulant (NOAC)double antiplatelet therapy (DAPT)ischemic eventsbleedingpercutaneous coronary intervention (PCI)

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