rpcardioRational Pharmacotherapy in CardiologyРациональная Фармакотерапия в Кардиологии1819-64462225-3653«SILICEA-POLIGRAF» LLC10.20996/1819-6446-2012-8-4-531-537rpcardio-494Research ArticlePOINT OF VIEWТОЧКА ЗРЕНИЯALTERNATIVE APPROACHES TO THE USE OF TWO COMPONENT ANTIPLATELET THERAPY IN PATIENTS WITH ACUTE CORONARY SYNDROME: EVIDENCES, RECOMMENDATIONS AND REAL PRACTICEАЛЬТЕРНАТИВНЫЕ ПОДХОДЫ К ПРИМЕНЕНИЮ ДВУХКОМПОНЕНТНОЙ АНТИАГРЕГАНТНОЙ ТЕРАПИИ У БОЛЬНЫХ С ОСТРЫМ КОРОНАРНЫМ СИНДРОМОМ: ДОКАЗАТЕЛЬСТВА, РЕКОМЕНДАЦИИ И РЕАЛЬНАЯ ПРАКТИКАГиляревскийС. Р.GilyarevskiyS. R.

д.м.н., профессор кафедры клинической фармакологии и терапии

ОрловВ. А.OrlovV. A.

д.м.н., профессор, заведующий кафедрой клинической фармакологии и терапии

КузьминаИ. М.Kuz'minaI. M.

к.м.н., в.н.с. отделения неотложной кардиологии

ЛаринА. Г.LarinA. G.

м.н.с. отделения рентгенохирургических методов лечения

Российская медицинская академия последипломного образованияРоссияRussian Medical Academy of Postgraduate EducationRussian FederationНаучно-исследовательский институт скорой помощи им. Н.В. СклифосовскогоРоссияResearch Institute of Emergency Medicine named after N.V. SklifosovskyRussian Federation20120201201684531537Copyright © Gilyarevskiy S.R., Orlov V.A., Kuz'mina I.M., Larin A.G., 20152015Гиляревский С.Р., Орлов В.А., Кузьмина И.М., Ларин А.Г.Gilyarevskiy S.R., Orlov V.A., Kuz'mina I.M., Larin A.G.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.rpcardio.online/jour/article/view/494

Alternative approaches to the use of two component antiplatelet therapy in patients with acute coronary syndrome are discussed. Reasons to the development and implementation of new, more powerful antiplatelet agents are considered. Besides the evidence base for the practical application of new antiplatelet agents is discussed, especially this for ticagrelor which is the first-line drug in acute coronary syndrome according to European clinical guidelines. Subjective limitations of ticagrelor use in clinical practice are discussed, as well as a basis for overcoming these limitations.

Обсуждаются альтернативные подходы к применению двухкомпонентной антиагрегантной терапии у больных с острым коронарным синдромом. Рассматриваются предпосылки к созданию и внедрению в практику новых, более мощных антиагрегантов, а также подробно обсуждается доказательная база практического применения новых антиагрегантов, в первую очередь, тикагрелора, который, в соответствии с Европейскими клиническими рекомендациями, при остром коронарном синдроме становится препаратом первого ряда. Обсуждаются субъективные факторы, препятствующие увеличению частоты использования тикагрелора в условиях реальной клинической практики, а также основания для преодоления таких ограничений.

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