medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2021-12-8-16medsovet-6326Research ArticleКАРДИОЛОГИЯCARDIOLOGYБезопасность и эффективность ацетилсалициловой кислоты при вторичной профилактике сердечно-сосудистых заболеваний в сочетании с коморбидными заболеваниями. Возможности лечения при COVID-19Safety and efficacy of acetylsalicylic acid in the secondary prevention of cardiovascular diseases in combination with comorbid diseases. COVID-19 treatment optionshttps://orcid.org/0000-0001-6546-3450ЦветковаО. А.TsvetkovaO. A.

д.м.н., профессор кафедры госпитальной терапии № 1,

119991, Москва, ул. Б. Пироговская, д. 6, стр. 1

Dr. Sci. (Med.), Professor of the Department of Hospital Therapy No. 1,

6, Bldg. 1, B. Pirogovskaya St., Moscow, 119991

oatsvetkova@mail.ruhttps://orcid.org/0000-0002-4705-8037ВоронковаО. О.VoronkovaO. O.

к.м.н., ассистент кафедры кафедры госпитальной терапии №  1,

119991, Москва, ул. Б. Пироговская, д. 6, стр. 1

Cand. Sci. (Med.), Assistant of the Department of Hospital Therapy No. 1,

6, Bldg. 1, B. Pirogovskaya St., Moscow, 119991

voronkova.oo@gmail.comИнститут клинической медицины имени Н.В. Склифосовского Первого Московского государственного медицинского университета имени И.М. Сеченова (Сеченовского Университета)РоссияSklifosovsky Institute of Clinical Medicine, Sechenov First Moscow State Medical University (Sechenov University)Russian Federation202110092021012816Copyright © Цветкова О.А., Воронкова О.О., 20212021Цветкова О.А., Воронкова О.О.Tsvetkova O.A., Voronkova O.O.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/6326

Вторичная профилактика сердечно-сосудистых заболеваний ацетилсалициловой кислотой (АСК) является очень важным вопросом. АСК обеспечивает предотвращение преждевременной смерти, торможение прогрессирования и  достижение частичного регресса атеросклероза коронарных артерий, предупреждение клинических осложнений и обострений болезни, уменьшение количества случаев и сроков госпитализации. Назначение АСК явилось тем важным методом, который оказал большое влияние на  профилактику сердечно-сосудистых заболеваний и  их осложнений, что связано с  двумя факторами: увеличением продолжительности жизни населения Земли в целом и стойким лидированием ишемической болезни сердца и мозгового инсульта как ведущих причин смерти, инвалидности и потери трудоспособности. Обсуждаются патогенетические аспекты назначения АСК. Наиболее распространенной лекарственной формой низкодозовых (нд) препаратов АСК для профилактического применения является кишечнорастворимая таблетка – 80,6% в структуре препаратов ндАСК. Низкодозовые АСК представлены в основном в виде монопрепаратов (84,4%), содержащих в качестве активного действующего вещества только АСК, чаще всего в дозе 100 мг. Однако побочные действия АСК ограничивают ее прием. Это обусловлено также большой частотой коморбидных заболеваний, таких как бронхиальная астма и язвенная болезнь желудка. В статье обсуждаются вопросы назначения АСК и  возможностей лечения больных с  сопутствующей бронхиальной астмой, язвенной болезнью желудка и ожирением. Распространенность гастродуоденальных повреждений была значительно ниже при применении АСК с кишечным покрытием, чем при применении буферной АСК. Продемонстрировано, что эндоскопические поражения слизистой оболочки гастродуоденальной области были значительно менее вероятны при применении АСК с кишечным покрытием (100 мг/сут), чем при применении обычной АСК, и оценка поражения при применении АСК с кишечным покрытием была аналогична оценке плацебо без АСК. В свете пандемии CОVID-19 обсуждается вопрос о возможностях включения АСК в схему лечения данной инфекции. 

Secondary prevention of cardiovascular disease with aspirin is a very important issue. Аcetylsalicylic acid ensures the prevention of premature death, inhibition of progression and the achievement of partial regression of coronary atherosclerosis, prevention of clinical complications and exacerbations of the disease, reduction of the number of cases and the duration of hospitalization. The most promising direction of modern cardiology is considered to be the prevention of cardiovascular diseases (CVD) and their complications (CVD). This is due to two factors: an increase in the life expectancy of the world’s population as a whole and the persistent leadership of coronary heart disease and brain stroke as the leading causes of death, and disability. The pathogenetic aspects of the administration of acetylsalicylic acid are discussed. The most common dosage form of low-dose (ld) preparations of acetylsalicylic acid (ASA) for preventive use is an intestinal-soluble tablet — 80.6% in the structure of ldASK preparations. Low-dose ASK preparations are mainly presented (84.4%) in the form of monopreparations containing only ASA as the active substance, most often at a dose of 100 mg. However, the side effects of aspirin limit drug intake. This is also due to the high frequency of comorbid diseases such as bronchial asthma and stomach ulcer. The article discusses the issue of prescribing acetylsalicylic acid and the possibility of treating patients with concomitant bronchial asthma, gastric ulcer and obesity. The prevalence of gastroduodenal lesions was significantly lower with intestinal-coated ASA than with buffered acetylsalicylic acid. It was demonstrated that endoscopic lesions of the gastroduodenal mucosa were significantly less likely when using intestinal-coated ASA (100 mg / day) than when using conventional аcetylsalicylic acid, and the assessment of the lesion when using intestinalcoated ASA was similar to the assessment of placebo without аcetylsalicylic acid. In addition, the issue of the possibility of including аcetylsalicylic acid in the treatment regimen for COVID 19 is being discussed. 

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