medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2019-5-20-29medsovet-2910Research ArticleАнтитромботическая терапияAntithrombotic therapyКлопидогрел в составе двойной дезагрегантной терапии при ОКС: обоснованный выбор в сложных клинических ситуацияхClopidogrel as a part of double disaggregant therapy in ACS: a reasonable choice in complex clinical situationsКашталапВ. В.KashtalapV. V.

Кашталап Василий Васильевич – д.м.н., заведующий лабораторией патофизиологии мультифокального атеросклероза отдела мультифокального атеросклероза. 

 650002, Россия, г. Кемерово, Сосновый бульвар, д. 6 ; 650056, Россия, г. Кемерово, ул. Ворошилова, д. 22а. 

Kashtalap Vasily Vasilievich – M.D., Ph.D., the Head of the Laboratory for Pathophysiology of Multivessel and Polyvascular Disease, the Department of Polyvascular and Multivessel Disease; Associate Professor at the Cardiology and Cardiovascular Surgery Department.

 6, Sosnoviy bulvar, Kemerovo, 650002; 22a, Voroshilova st., Kemerovo, 650029.

v_kash@mail.ruБарбарашО. Л.BarbarashO. L.

 Барбараш Ольга Леонидовна – д.м.н., профессор, чл.-корр. Российской академии наук, заведующая кафедрой кардиологии и сердечно-сосудистой хирургии.

650002, Россия, г. Кемерово, Сосновый бульвар, д. 6 ; 650056, Россия, г. Кемерово, ул. Ворошилова, д. 22а. 

Barbarash Olga Leonidovna – M.D., Ph.D., Professor, associate member of Russian Academy of Sciences, Director; Chairman of the Cardiology and Cardiovascular Surgery Department.

 6, Sosnoviy bulvar, Kemerovo, 650002; 22a, Voroshilova st., Kemerovo, 650029.

olb61@mail.ruФедеральное государственное бюджетное научное учреждение «Научно-исследовательский институт комплексных проблем сердечно-сосудистых заболеваний»; Федеральное государственное бюджетное образовательное учреждение высшего образования «Кемеровский государственный медицинский университет» Министерства здравоохранения Российской Федерации.РоссияFederal State Budgetary Institution «Research Institute for Complex Issues of Cardiovascular Diseases»; Federal State Budget Educational Institution of Higher Education «Kemerovo State Medical University» the Ministry of Health of the Russian Federation.Russian Federation201902042019052029Copyright © Кашталап В.В., Барбараш О.Л., 20192019Кашталап В.В., Барбараш О.Л.Kashtalap V.V., Barbarash O.L.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/2910

В статье на основании рекомендаций Европейского кардиологического общества и результатов клинических и регистровых исследований освещены сложные вопросы, возникающие при назначении антитромботической терапии у пациентов с острым коронарным синдромом, в т. ч. с сопутствующей фибрилляцией предсердий (ФП); описаны перспективные стратегии управления риском ишемических и геморрагических событий. Также представлен клинический случай пациента с острым коронарным синдромом и ФП, иллюстрирующий объективную сложность корректного подбора антитромботической терапии у таких больных.

Based on the recommendations of the European Heart Society and the results of clinical and register studies, the article highlights the complex issues that arise when prescribing antiplatelet therapy in patients with acute coronary syndrome, including with concomitant atrial fibrillation (AF); the promising strategies for managing the risk of ischemic and hemorrhagic events are described. Also a clinical case of a patient with acute coronary syndrome and AF is presented, illustrating the objective complexity of correct selection of antiplatelet therapy in such patients.

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