medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2019-18-10-17medsovet-4871Research ArticleЦЕРЕБРОВАСКУЛЯРНЫЕ ЗАБОЛЕВАНИЯCEREBROVASCULAR DISEASESИшемический инсульт и антитромботическая терапия: ключевые аспекты примененияIschemic stroke and antithrombotic therapy: key aspectsМаксимоваМ. Ю.MaksimovaM. Yu.

Максимова Марина Юрьевна, д.м.н., профессор, заведующая 2-м неврологическим отделением

125367,  Москва, Волоколамское шоссе, д. 80

Marina Yu. Maksimova, Dr. of Sci. (Med), professor, Head of the 2nd Neurological Department

80, Volokolamskoe shosse, Moscow, 125367

center@neurology.ruФонякинА. В.FonyakinA. V.

Фонякин Андрей Викторович, д.м.н., профессор, руководитель лаборатории кардионеврологии 2-го неврологического отделения, ведущий научный сотрудник

125367,  Москва, Волоколамское шоссе, д. 80

Andrey V. Fonyakin, Dr. of Sci. (Med), professor, Head of the Cardio-Neurology Laboratory of the 2nd Neurological Department, leading researcher

80, Volokolamskoe shosse, Moscow, 125367

ГераскинаЛ. А.GeraskinaL. A.

Гераскина Людмила Александровна, д.м.н., профессор, ведущий научный сотрудник лаборатории кардионеврологии 2-го неврологического отделения

125367,  Москва, Волоколамское шоссе, д. 80

Lyudmila A. Geraskina, Dr. of Sci. (Med), professor, Leading Researcher of the Cardio-Neurology Laboratory of the 2nd Neurological Department

80, Volokolamskoe shosse, Moscow, 125367

Научный центр неврологииРоссияFederal State Budgetary Scientific Institution «Research Center of Neurology»Russian Federation2019301120190181017Copyright © Максимова М.Ю., Фонякин А.В., Гераскина Л.А., 20192019Максимова М.Ю., Фонякин А.В., Гераскина Л.А.Maksimova M.Y., Fonyakin A.V., Geraskina L.A.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/4871

В статье рассмотрены стратегические направления антитромботической терапии при ишемическом инсульте. Показано, что антитромботическое лечение данной категории пациентов представляет собой многоступенчатую и мультидисциплинарную проблему, начинающуюся с появления первых неврологических симптомов и продолжающуюся в течение всей последующей жизни. Каждый период, включая темпы доставки больного в стационар, последующие действия медицинского персонала, принятие мер по лечению инсульта, профилактике повторных церебральных нарушений, кардиальных осложнений, важен сам по себе и служит единой цели. В конечном итоге все усилия должны быть направлены на уменьшение летальности в острой фазе инсульта, функциональной зависимости пациента, снижение рецидивов церебрального поражения, неотъемлемое пожизненное следование принципам вторичной профилактики сердечно-сосудистых осложнений для увеличения продолжительности и качества жизни.

The paper considers the key areas of antithrombotic therapy for ischemic stroke (IS). Antiplatelet therapy is shown to be a multistage and multidisciplinary strategy of treatment for patients with IS, which begins with the appearance of the first symptoms of the disease and continues throughout life. Each stage, including fibrinolytic therapy, early use of antithrombotic and anticoagulant drugs, and personalized antithrombotic prevention of recurrent cerebral disorders, is important in itself and serves a common goal. As a result, all efforts should be aimed at reducing mortality rates in the acute phase of stroke and the functional dependence of a patient and at preventing venous thromboses, recurrent stroke, and all cardiovascular events to increase life expectancy and to improve quality of life. Fibrinolytic therapy increases the patient’s chances of a full neurologic recovery and improves the quality of later life. Antithrombotic drugs reduce the risk of cardiovascular death, early recurrences of stroke, and recurrent noncardioembolic stroke. Parenteral anticoagulants in acute stroke decrease the risk of venous thrombosis/thromboembolism, oral anticoagulants reduce that of recurrent cardioembolic stroke.

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