medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2017-12-138-143medsovet-2045Research ArticleТРОМБОЗЫ И ТРОМБОЭМБОЛИИTHROMBOSIS AND THROMBOEMBOLISMВОЗОБНОВЛЕНИЕ АНТИТРОМБОТИЧЕСКОЙ ТЕРАПИИ У БОЛЬНЫХ ИБС ПОСЛЕ ЭПИЗОДА КРОВОТЕЧЕНИЯRESTORATION OF ANTITHROMBOTIC THERAPY IN IBS PATIENTS AFTER EPISODE OF BLEEDINGСумароковА. Б.SumarokovA. B.

к.м.н.

PhD in medicine

ДоценкоЮ. В.DotsenkoY. V.

к.м.н. 

PhD

Институт клинической кардиологии им. А.Л. Мясникова Российского кардиологического научно-производственного комплекса Минздрава России,РоссияMyasnikov Institute of Clinical Cardiology FSBI RCNIC of the MInistry of Health of RussiaRussian Federation201704112017012138143Copyright © Сумароков А.Б., Доценко Ю.В., 20172017Сумароков А.Б., Доценко Ю.В.Sumarokov A.B., Dotsenko Y.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/2045

Лечение антитромботическими препаратами является балансированием между риском появления кровоточивости, вплоть до фатального кровотечения, и риском непредотвращенного тромбоза. В случае состоявшегося кровотечения проблемы сохранения баланса гемостаза многократно возрастают, что требует от врача четкого понимания и предвидения развития возможных осложнений. Полный отказ от антитромботической терапии (АТТ) сразу после кровотечения может привести к реальной угрозе тромбоза через несколько дней после отмены. Обсуждена тактика возобновления АТТ у больных ИБС после кровотечения: приведены основные классификации кровотечений, применяемые при сердечно-сосудистых заболеваниях (ССЗ), разобраны шкалы риска кровотечений и тромбоза в свете последних (ноябрь 2016 г.) рекомендаций экспертов Европейского общества кардиологов (ЕОК).

 

 

 

 

Rational balance between risks of bleeding and risks of thrombosis is cornerstone of modern antithrombotic therapy. Regulation of haemostasis has no any physical signs. In a case of bleeding careful management is of great importance. Abrupt discontinuation of antithrombotic therapy is associated with some degree of thrombosis risk. Problems of re-initiation of antithrombotic therapy in CAD patients after bleeding are discussed.

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