medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2022-16-6-273-279medsovet-6840Research ArticleПРАКТИКАPRACTICEПути оптимизации лечения пациентов с различными формами ишемической болезни сердцаHow to optimize treatment in patients with different forms of coronary artery diseasehttps://orcid.org/0000-0002-2870-3301ГиляровМ. Ю.GilyarovM. Yu.

д.м.н., заместитель главного врача по терапевтической помощи, 119049, Москва, Ленинский проспект, д. 8;

заведующий кафедрой интервенционной кардиологии и кардиореабилитации, 117997, Москва, ул. Островитянова, д. 1

Dr. Sci. (Med.), Deputy Chief Physician for Therapeutic Care, 8, Leninsky Ave., Moscow, 119049;

Head of the Department of Interventional Cardiology and Cardiac Rehabilitation, 1, Ostrovityanov St., Moscow, 117997

gilarov@gmail.comhttps://orcid.org/0000-0003-4918-3795КонстантиноваЕ. В.KonstantinovaE. V.

д.м.н., доцент кафедры факультетской терапии имени академика А.И. Нестерова лечебногофакультета, профессор кафедры интервенционной кардиологии и кардиореабилитации,

117997, Москва, ул. Островитянова, д. 1

Dr. Sci. (Med.), Associate Professor of the Department of Faculty Therapy named after Academician A.I. Nesterov of the Faculty of Medicine, Professor of the Department of Interventional Cardiology and Cardiac Rehabilitation, 

1, Ostrovityanov St., Moscow, 117997

katekons@mail.ruГородская клиническая больница №1 имени Н.И. Пирогова; Российский национальный исследовательский медицинский университет имени Н.И. ПироговаРоссияCity Clinical Hospital No. 1 named after N.I. Pirogov; Pirogov Russian National Research Medical UniversityRussian FederationРоссийский национальный исследовательский медицинский университет имени Н.И. ПироговаРоссияPirogov Russian National Research Medical UniversityRussian Federation20222704202206273279Copyright © Гиляров М.Ю., Константинова Е.В., 20222022Гиляров М.Ю., Константинова Е.В.Gilyarov M.Y., Konstantinova E.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/6840

Ишемическая болезнь сердца  (ИБС) сохраняет лидирующие позиции по  показателям заболеваемости и  смертности как в нашей стране, так и во многих странах мира. ИБС имеет многообразные острые и хронические клинические формы и может наблюдаться у пациентов с различной кардиальной и внекардиальной патологией. Для улучшения прогноза каждого пациента с  ИБС необходима персонализация проводимой терапии. Данные исследования COMPASS показали, что у пациентов со стабильной ИБС, высоким риском тромботических осложнений и невысоким риском кровотечений для  профилактики развития атеротромботических сердечно-сосудистых событий, наряду с  длительным использования ацетилсалициловой кислоты, целесообразно назначение ривароксабана в дозе 2,5 мг 2 раза в сутки. Клиническая польза применения такой комбинированной терапии особенно высока при наличии у  пациентов сахарного диабета. После выполнения чрескожного коронарного вмешательства (ЧКВ) у пациента с ИБС и фибрилляцией предсердий (ФП) встает задача минимизировать риск как атеротромботического события, включая возможность тромбоза стента, так и развитие ишемического инсульта, учитывая возрастающий вследствие проведения такой терапии риск развития кровотечения. Результаты исследования PIONEER AF-PCI послужили основанием рекомендовать ривароксабан в дозе 15 мг в составе комплексной антитромботической терапии для этой группы пациентов с ФП. При наличии синусового ритма у пациентов со сниженной фракцией выброса левого желудочка и высоким тромбоэмболическим риском можно рассмотреть возможность добавления к  терапии ривароксабана для снижения частоты неврологических событий, как это было показано в исследовании COMMANDER HF. Таким образом, накоплен большой объем доказательств возможности применения ривароксабана как важного компонента комплексной терапии пациентов с ИБС в различных клинических ситуациях. 

Coronary artery disease (CAD) retains top positions in terms of morbidity and mortality both in our country and many countries of the world. CAD takes many acute and chronic clinical forms and can be observed in patients with various cardiac and extracardiac pathologies. The therapy should be personalized to improve the prognosis for each patient with CAD. The COMPASS trial showed that administration of rivaroxaban at a dose of 2.5 mg twice daily combined with a longterm use of acetylsalicylic acid is reasonable in patients with stable coronary artery disease, a high risk of thrombotic complications and a low risk of bleeding to prevent the development of atherothrombotic cardiovascular events. The clinical benefit of this combination therapy is especially high in patients with diabetes mellitus. Once the percutaneous coronary intervention (PCI) is performed in a patient with CAD and atrial fibrillation (AF), we face the task to minimize the risk of atherothrombotic events, including the possibility of stent thrombosis, and the development of ischemic stroke, given the increased risk of bleeding due to such therapy. The results of PIONEER AF-PCI trial have become the  grounds for recommendation of rivaroxaban 15 mg as part of combination antithrombotic therapy for this group of  patients with AF. An option to add rivaroxaban to therapy may be considered in the presence of sinus rhythm in patients with reduced left ventricular ejection fraction and high thromboembolic risk to reduce the incidence of neurological events, as was shown in the COMMANDER HF trial. So there is a wealth of evidence that rivaroxaban may be used as an important component of the combination therapy of patients with CAD in a variety of clinical situations.

ишемическая болезнь сердцаривароксабанриск атеротромботических событийгеморрагический рискфибрилляция предсердийриск кардиоэмболийcoronary heart diseaserivaroxabanrisk of atherothrombotic eventshemorrhagic riskatrial fibrillationrisk of cardioembolismReferencesBenjamin E.J., Blaha M.J., Chiuve S.E., Cushman M., Das S.R., Deo R. et al. Heart Disease and Stroke Statistics-2017 Update: A Report From the American Heart Association. Circulation. 2017;135(10):е146–е603. https://doi.org/10.1161/CIR.0000000000000485.Benjamin E.J., Blaha M.J., Chiuve S.E., Cushman M., Das S.R., Deo R. et al. Heart Disease and Stroke Statistics-2017 Update: A Report From the American Heart Association. Circulation. 2017;135(10):е146–е603. https://doi.org/10.1161/CIR.0000000000000485.GBD 2013 Mortality and Causes of Death Collaborators. Global, regional, and national age-sex specific all-cause and cause-cpecific mortality for 240 causes of death, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2015;385(9963):117–171. https://doi.org/10.1016/S0140-6736(14)61682-2.GBD 2013 Mortality and Causes of Death Collaborators. Global, regional, and national age-sex specific all-cause and cause-cpecific mortality for 240 causes of death, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2015;385(9963):117–171. https://doi.org/10.1016/S0140-6736(14)61682-2.Леонов С.А., Голубев Н.А., Зайченко Н.М. Сборник статистических материалов по болезням системы кровообращения. М.; 2017, 295 с. Режим доступа: https://mednet.ru/images/stories/files/CMT/kardioilogiya_2017.pdf?ysclid=l1ewczw1e.Leonov S.A., Golubev N.A., Zaichenko N.M. Collection of statistical materials on diseases of the circulatory system. Moscow; 2017. 295 р. (In Russ.) Available at: https://mednet.ru/images/stories/files/CMT/kardioilogiya_2017.pdf?ysclid=l1ewczw1e.Барбараш О.Л., Карпов Ю.А., Кашталап В.В., Бощенко А.А., Руда М.М., Акчурин Р.С. и др. Стабильная ишемическая болезнь сердца. Клинические рекомендации 2020. Российский кардиологический журнал. 2020;(11):4076. https://doi.org/10.15829/29/1560-4071-2020-4076.Barbarash O.L., Karpov Yu.A., Kashtalap V.V., Boschenko A.A., Ruda M.M., Akchurin R.S. et al. 2020 Clinical practice guidelines for Stable coronary artery disease. Russian Journal of Cardiology. 2020;(11):4076. (In Russ.) https://doi.org/10.15829/29/1560-4071-2020-4076.Thygesen K., Alpert J.S., Jaffe A.S., Chaitman B.R., Bax J.J., Morrow D.A., White H.D. Fourth universal definition of myocardial infarction (2018). J Am Coll Cardiol. 2018;72(18):2231–2264. https://doi.org/10.1016/j.jacc.2018.08.1038.Thygesen K., Alpert J.S., Jaffe A.S., Chaitman B.R., Bax J.J., Morrow D.A., White H.D. Fourth universal definition of myocardial infarction (2018). J Am Coll Cardiol. 2018;72(18):2231–2264. https://doi.org/10.1016/j.jacc.2018.08.1038.Collet J.P., Thiele H., Barbato E., Barthélémy O., Bauersachs J., Bhatt D.L. et al. 2020 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation: The Task Force for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation of the European Society of Cardiology (ESC). Eur Heart J. 2021;42(14):1289–1367. https://doi.org/10.1093/eurheartj/ehaa575.Collet J.P., Thiele H., Barbato E., Barthélémy O., Bauersachs J., Bhatt D.L. et al. 2020 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation: The Task Force for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation of the European Society of Cardiology (ESC). Eur Heart J. 2021;42(14):1289–1367. https://doi.org/10.1093/eurheartj/ehaa575.Чазов Е.И., Кухарчук В.В., Бойцов С.А. (ред.). Руководство по атеросклерозу и ишемической болезни сердца. М.; 2007. 735 с. Режим доступа: https://search.rsl.ru/ru/record/01003393519.Chazov E.I., Kukharchuk V.V., Boitsov S.A. (eds.). Guidelines for atherosclerosis and coronary heart disease. Moscow; 2007. 735 р. (In Russ.) Available at: https://search.rsl.ru/ru/record/01003393519.Stone G.W., Maehara A., Lansky A.J., de Bruyne B., Cristea E., Mintz G.S. et al. A prospective natural-history study of coronary atherosclerosis. N Engl J Med. 2011;364(3):226–235. https://doi.org/10.1056/NEJMoa1002358.Stone G.W., Maehara A., Lansky A.J., de Bruyne B., Cristea E., Mintz G.S. et al. A prospective natural-history study of coronary atherosclerosis. N Engl J Med. 2011;364(3):226–235. https://doi.org/10.1056/NEJMoa1002358.Baigent C., Blackwell L., Collins R., Emberson J., Godwin J., Peto R. et al. Aspirin in the primary and secondary prevention of vascular disease: collaborative meta-analysis of individual participant data from randomized trials. Lancet. 2009;373(9668):1849–1860. https://doi.org/10.1016/S0140-6736(09)60503-1.Baigent C., Blackwell L., Collins R., Emberson J., Godwin J., Peto R. et al. Aspirin in the primary and secondary prevention of vascular disease: collaborative meta-analysis of individual participant data from randomized trials. Lancet. 2009;373(9668):1849–1860. https://doi.org/10.1016/S0140-6736(09)60503-1.Abtan J., Bhatt D.L., Elbez Y., Sorbets E., Eagle K., Ikeda Y. et al. Residual Ischemic Risk and Its Determinants in Patients With Previous Myocardial Infarction and Without Prior Stroke or TIA: Insights From the REACH Registry. Clin Cardiol. 2016;39(11):670–677. https://doi.org/10.1002/clc.22583.Abtan J., Bhatt D.L., Elbez Y., Sorbets E., Eagle K., Ikeda Y. et al. Residual Ischemic Risk and Its Determinants in Patients With Previous Myocardial Infarction and Without Prior Stroke or TIA: Insights From the REACH Registry. Clin Cardiol. 2016;39(11):670–677. https://doi.org/10.1002/clc.22583.Панченко Е.П., Беленков Ю.Н. Характеристика и исходы атеротромбоза у амбулаторных больных в Российской Федерации (по материалам международного регистра REACH). Кардиология. 2008;(2):17–24. Режим доступа: https://elibrary.ru/item.asp?id=9940170.Panchenko E.P., Belenkov Yu.N. Characteristics and outcomes of atherothrombosis in outpatient patients in the Russian Federation (based on the materials of the REACH international registry). Kardiologiya. 2008;(2):17–24. (In Russ.) Available at: https://elibrary.ru/item.asp?id=9940170.Li M.F., Zhao C.C., Li T.T., Tu Y.F., Lu J.X., Zhang R. et al. The coexistence of carotid and lower extremity atherosclerosis further increases cardiocerebrovascular risk in type 2 diabetes. Cardiovasc Diabetol. 2016;15:43. https://doi.org/10.1186/s12933-016-0360-2.Li M.F., Zhao C.C., Li T.T., Tu Y.F., Lu J.X., Zhang R. et al. The coexistence of carotid and lower extremity atherosclerosis further increases cardiocerebrovascular risk in type 2 diabetes. Cardiovasc Diabetol. 2016;15:43. https://doi.org/10.1186/s12933-016-0360-2.Banerjee S., Vinas A., Mohammad A., Hadidi O., Thomas R., Sarode K. et al. Significance of an abnormal ankle-brachial index in patients with established coronary artery disease with and without associated diabetes mellitus. Am J Cardiol. 2014;113(8):1280–1284. https://doi.org/10.1016/j.amjcard.2014.01.403.Banerjee S., Vinas A., Mohammad A., Hadidi O., Thomas R., Sarode K. et al. Significance of an abnormal ankle-brachial index in patients with established coronary artery disease with and without associated diabetes mellitus. Am J Cardiol. 2014;113(8):1280–1284. https://doi.org/10.1016/j.amjcard.2014.01.403.Генкель В.В., Салашенко А.О., Шамаева Т.Н., Сумеркина В.А., Никушкина К.В., Шапошник И.И. Атеросклероз периферических артерий у пациентов с ишемической болезнью сердца и сахарным диабетом 2-го типа. Терапевтический архив. 2019;(10):54–62. https://doi.org/10.26442/00403660.2019.10.000106.Genkel V.V., Salashenko A.O., Shamaeva T.N., Sumerkina V.A., Nikushkina K.V., Shaposhnik I.I. Atherosclerosis of peripheral arteries in patients with coronary artery disease and type 2 diabetes mellitus. Terapevticheskii Arkhiv. 2019;(10):54–62. (In Russ.) https://doi.org/10.26442/00403660.2019.10.000106.Eikelboom J.W., Connolly S.J., Bosch J., Dagenais G.R., Hart R.G., Shestakovska O. et al. Rivaroxaban with or without Aspirin in Stable Cardiovascular Disease. N Engl J Med. 2017;377(14):1319–1330. https://doi.org/10.1056/NEJMoa1709118.Eikelboom J.W., Connolly S.J., Bosch J., Dagenais G.R., Hart R.G., Shestakovska O. et al. Rivaroxaban with or without Aspirin in Stable Cardiovascular Disease. N Engl J Med. 2017;377(14):1319–1330. https://doi.org/10.1056/NEJMoa1709118.Knuuti J., Wijns W., Saraste A., Capodanno D., Barbato E., Funck-Brentano C. et al. 2019 ESC Guidelines for the diagnosis and management of chronic coronary syndromes. Eur Heart J. 2020;41(3):407–477. https://doi.org/10.1093/eurheartj/ehz425.Knuuti J., Wijns W., Saraste A., Capodanno D., Barbato E., Funck-Brentano C. et al. 2019 ESC Guidelines for the diagnosis and management of chronic coronary syndromes. Eur Heart J. 2020;41(3):407–477. https://doi.org/10.1093/eurheartj/ehz425.Connolly S.J., Eikelboom J.W., Bosch J., Dagenais G., Dyal L., Lanas F. et al. Rivaroxaban with or without aspirin in patients with stable coronary artery disease: an international, randomised, double-blind, placebocontrolled trial. Lancet. 2018;391(10117):205–218. https://doi.org/10.1016/S0140-6736(17)32409-1.Connolly S.J., Eikelboom J.W., Bosch J., Dagenais G., Dyal L., Lanas F. et al. Rivaroxaban with or without aspirin in patients with stable coronary artery disease: an international, randomised, double-blind, placebocontrolled trial. Lancet. 2018;391(10117):205–218. https://doi.org/10.1016/S0140-6736(17)32409-1.Кухарчук В.В., Ежов М.В., Сергиенко И.В., Арабидзе Г.Г., Бубнова М.Г., Балахонова Т.В. и др. Диагностика и коррекция нарушений липидного обмена с целью профилактики и лечения атеросклероза. Российские рекомендации, VII пересмотр. Атеросклероз и дислипидемии. 2020;(1):7–42. Режим доступа: https://cyberleninka.ru/article/n/diagnostika-i-korrektsiya-narusheniy-lipidnogo-obmena-s-tselyuprofilaktiki-i-lecheniya-ateroskleroza-rossiyskie-rekomendatsii-vii.Kukharchuk V.V., Ezhov M.V., Sergienko I.V., Arabidze G.G., Bubnova M.G., Balakhonova T.V. et al. Diagnostics and correction of lipid metabolism disorders in order to prevent and treat atherosclerosis. Russian recommendations VII revision. The Journal of Atherosclerosis and Dyslipidemias. 2020;(1):7–42. (In Russ.) Available at: https://cyberleninka.ru/article/n/diagnostika-i-korrektsiya-narusheniy-lipidnogo-obmena-s-tselyuprofilaktiki-i-lecheniya-ateroskleroza-rossiyskie-rekomendatsii-vii.Сумин А.Н., Безденежных Н.А., Безденежных А.В., Осокина А.В., Кузьмина А.А., Груздева О.В., Барбараш О.Л. Предоперационный статус и госпитальные осложнения коронарного шунтирования у пациентов с предиабетом и сахарным диабетом 2-го типа. Российский кардиологический журнал. 2018;(5):40–48. https://doi.org/10.15829/1560-4071-2018-5-40-48.Sumin A.N., Bezdenezhnykh N.A., Bezdenezhnykh A.V., Osokina A.V., Kuzmina A.A., Gruzdeva О.V., Barbarash О.L. Pre-surgery status and in-hospital complications of coronary bypass grafting in prediabetes and type 2 diabetes patients. Russian Journal of Cardiology. 2018;(5):40–48. (In Russ.) https://doi.org/10.15829/1560-4071-2018-5-40-48.de la Hera J.M., Delgado E., Hernandez E., García-Ruiz J.M., Vegas J.M., Avanzas P. et al. Prevalence and outcome of newly detected diabetes in patients who undergo percutaneous coronary intervention. Eur Heart J. 2009;30(21):2614–2621. https://doi.org/10.1093/eurheartj/ehp278.de la Hera J.M., Delgado E., Hernandez E., García-Ruiz J.M., Vegas J.M., Avanzas P. et al. Prevalence and outcome of newly detected diabetes in patients who undergo percutaneous coronary intervention. Eur Heart J. 2009;30(21):2614–2621. https://doi.org/10.1093/eurheartj/ehp278.Gutierrez J.A., Scirica B.M., Bonaca M.P., Steg P.G., Mosenzon O., Hirshberg B. et al. Prevalence and Outcomes of Polyvascular (Coronary, Peripheral, or Cerebrovascular) Disease in Patients With Diabetes Mellitus (From the SAVOR-TIMI 53 Trial). Am J Cardiol. 2019;123(1):145–152. https://doi.org/10.1016/j.amjcard.2018.09.014.Gutierrez J.A., Scirica B.M., Bonaca M.P., Steg P.G., Mosenzon O., Hirshberg B. et al. Prevalence and Outcomes of Polyvascular (Coronary, Peripheral, or Cerebrovascular) Disease in Patients With Diabetes Mellitus (From the SAVOR-TIMI 53 Trial). Am J Cardiol. 2019;123(1):145–152. https://doi.org/10.1016/j.amjcard.2018.09.014.Bhatt D.L., Eikelboom J.W., Connolly S.J., Steg P.G., Anand S.S., Verma S. et al. Role of Combination Antiplatelet and Anticoagulation Therapy in Diabetes and Cardiovascular Disease: Insights from the COMPASS Trial. Circulation. 2020;141(23):1841–1854. https://doi.org/10.1161/CIRCULATIONAHA.120.046448.Bhatt D.L., Eikelboom J.W., Connolly S.J., Steg P.G., Anand S.S., Verma S. et al. Role of Combination Antiplatelet and Anticoagulation Therapy in Diabetes and Cardiovascular Disease: Insights from the COMPASS Trial. Circulation. 2020;141(23):1841–1854. https://doi.org/10.1161/CIRCULATIONAHA.120.046448.Алекян Б.Г., Григорьян А.М., Стаферов А.В., Карапетян Н.Г. Рентгенэндоваскулярная диагностика и лечение заболеваний сердца и сосудов в Российской Федерации – 2017 год. Эндоваскулярная хирургия. 2018;2(5):93–240. https://doi.org/10.24183/2409-4080-2018-5-2-93-240.Alekyan B.G., Grigor’yan A.M., Staferov A.V., Karapetyan N.G. Endovascular diagnostics and treatment in the Russian Federation (2017). Russian Journal of Endovascular Surgery. 2018;2(5):93–240. (In Russ.) https://doi.org/10.24183/2409-4080-2018-5-2-93-240.Hindricks G., Potpara T., Dagres N., Arbelo E., Bax J.J., BlomströmLundqvist C. et al. 2020 ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association of Cardio-Thoracic Surgery (EACTS): The Task Force for the diagnosis and management of atrial fibrillation of the European Society of Cardiology (ESC) Developed with the special contribution of the European Heart Rhythm Association (EHRA) of the ESC. Eur Heart J. 2021;42(5):373–498. https://doi.org/10.1093/eurheartj/ehaa612.Hindricks G., Potpara T., Dagres N., Arbelo E., Bax J.J., BlomströmLundqvist C. et al. 2020 ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association of Cardio-Thoracic Surgery (EACTS): The Task Force for the diagnosis and management of atrial fibrillation of the European Society of Cardiology (ESC) Developed with the special contribution of the European Heart Rhythm Association (EHRA) of the ESC. Eur Heart J. 2021;42(5):373–498. https://doi.org/10.1093/eurheartj/ehaa612.Lamberts M., Olesen J.B., Ruwald M.H., Hansen C.M., Karasoy D., Kristensen S.L. et al. Bleeding after initiation of multiple antithrombotic drugs, including triple therapy, in atrial fibrillation patients following myocardial infarction and coronary intervention: a nationwide cohort study. Circulation. 2012;126(10):1185–1193. https://doi.org/10.1161/CIRCULATIONAHA.112.114967.Lamberts M., Olesen J.B., Ruwald M.H., Hansen C.M., Karasoy D., Kristensen S.L. et al. Bleeding after initiation of multiple antithrombotic drugs, including triple therapy, in atrial fibrillation patients following myocardial infarction and coronary intervention: a nationwide cohort study. Circulation. 2012;126(10):1185–1193. https://doi.org/10.1161/CIRCULATIONAHA.112.114967.Paikin J.S., Wright D.S., Crowther M.A., Mehta S.R., Eikelboom J.W. Triple antithrombotic therapy in patients with atrial fibrillation and coronary artery stents. Circulation. 2010;121(18):2067–2070. https://doi.org/10.1161/CIRCULATIONAHA.109.924944.Paikin J.S., Wright D.S., Crowther M.A., Mehta S.R., Eikelboom J.W. Triple antithrombotic therapy in patients with atrial fibrillation and coronary artery stents. Circulation. 2010;121(18):2067–2070. https://doi.org/ 10.1161/CIRCULATIONAHA.109.924944.Dewilde W.J., Oirbans T., Verheugt F.W., Kelder J.C., De Smet B.J., Herrman J.P. et al. Use of clopidogrel with or without aspirin in patients taking oral anticoagulant therapy and undergoing percutaneous coronary intervention: an open-label, randomised, controlled trial. Lancet. 2013;381(9872):1107–1115. https://doi.org/10.1016/S0140-6736(12)62177-1.Dewilde W.J., Oirbans T., Verheugt F.W., Kelder J.C., De Smet B.J., Herrman J.P. et al. Use of clopidogrel with or without aspirin in patients taking oral anticoagulant therapy and undergoing percutaneous coronary intervention: an open-label, randomised, controlled trial. Lancet. 2013;381(9872):1107–1115. https://doi.org/10.1016/S0140- 6736(12)62177-1.Lamberts M., Gislason G.H., Olesen J.B., Kristensen S.L., Schjerning Olsen A.M., Mikkelsen A. et al. Oral anticoagulation and antiplatelets in atrial fibrillation patients after myocardial infarction and coronary intervention. J Am Coll Cardiol. 2013;62(11):981–989. https://doi.org/10.1016/j.jacc.2013.05.029.Lamberts M., Gislason G.H., Olesen J.B., Kristensen S.L., Schjerning Olsen A.M., Mikkelsen A. et al. Oral anticoagulation and antiplatelets in atrial fibrillation patients after myocardial infarction and coronary intervention. J Am Coll Cardiol. 2013;62(11):981–989. https://doi.org/10.1016/j.jacc.2013.05.029.Gibson C.M., Mehran R., Bode C., Halperin J., Verheugt F.W., Wildgoose P. et al. Prevention of bleeding in patients with atrial fibrillation undergoing PCI. N Engl J Med. 2016;375(25):2423–2434. https://doi.org/10.1056/ NEJMoa1611594.Gibson C.M., Mehran R., Bode C., Halperin J., Verheugt F.W., Wildgoose P. et al. Prevention of bleeding in patients with atrial fibrillation undergoing PCI. N Engl J Med. 2016;375(25):2423–2434. https://doi.org/10.1056/ NEJMoa1611594.Asinger R.W., Mikell F.L., Elsperger J., Hodges M. Incidence of left-ventricular thrombosis after acute transmural myocardial infarction. Serial evaluation by twodimensional echocardiography. N Engl J Med. 1981;305(6):297–302. https://doi.org/10.1056/NEJM198108063050601.Asinger R.W., Mikell F.L., Elsperger J., Hodges M. Incidence of left-ventricular thrombosis after acute transmural myocardial infarction. Serial evaluation by twodimensional echocardiography. N Engl J Med. 1981;305(6):297–302. https://doi.org/10.1056/NEJM198108063050601.Bulluck H., Chan M.H.H., Paradies V., Yellon R.L., Ho H.H., Chan M.Y. et al. Incidence and predictors of left ventricular thrombus by cardiovascular magnetic resonance in acute ST-segment elevation myocardial infarction treated by primary percutaneous coronary intervention: a meta-analysis. J Cardiovasc Magn Reson. 2018;20(1):72. https://doi.org/10.1186/s12968-018-0494-3.Bulluck H., Chan M.H.H., Paradies V., Yellon R.L., Ho H.H., Chan M.Y. et al. Incidence and predictors of left ventricular thrombus by cardiovascular magnetic resonance in acute ST-segment elevation myocardial infarction treated by primary percutaneous coronary intervention: a meta-analysis. J Cardiovasc Magn Reson. 2018;20(1):72. https://doi.org/10.1186/s12968-018-0494-3.Collet J.P., Thiele H., Barbato E., Barthélémy O., Bauersachs J., Bhatt D.L. et al. 2020 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation. Eur Heart J. 2021;42(14):1289–1367. https://doi.org/10.1093/eurheartj/ehaa575.Collet J.P., Thiele H., Barbato E., Barthélémy O., Bauersachs J., Bhatt D.L. et al. 2020 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation. Eur Heart J. 2021;42(14):1289–1367. https://doi.org/10.1093/eurheartj/ehaa575.Барбараш О.Л., Дупляков Д.В., Затейщиков Д.А., Панченко Е.П., Шахнович Р.М., Явелов И.С. и др. Острый коронарный синдром без подъема сегмента ST электрокардиограммы. Клинические рекомендации 2020. Российский кардиологический журнал. 2021;(4):4449. https://doi.org/10.15829/1560-4071-2021-4449.Barbarash O.L., Duplyakov D.V., Zateischikov D.A., Panchenko E.P., Shakhnovich R.M., Yavelov I.S. et al. 2020 Clinical practice guidelines for Acute coronary syndrome without ST segment elevation. Russian Journal of Cardiology. 2021;(4):4449. (In Russ.) https://doi.org/10.15829/1560-4071-2021-4449.Fleddermann A., Hayes C., Magalski A., Main M.L. Efficacy of Direct Acting Oral Anticoagulants in Treatment of Left Ventricular Thrombus. Am J Cardiol. 2019;124(3):367–372. https://doi.org/10.1016/j.amjcard.2019.05.009.Fleddermann A., Hayes C., Magalski A., Main M.L. Efficacy of Direct Acting Oral Anticoagulants in Treatment of Left Ventricular Thrombus. Am J Cardiol. 2019;124(3):367–372. https://doi.org/10.1016/j.amjcard.2019.05.009.Perez P.M., Bravo S.D., Trigo G., Ruiz de Castroviejo V.E., Torres Llergo J., Lozano Cabezas C., Fernández Guerrero J.C. Resolution of left ventricular thrombus by rivaroxaban. Future Cardiol. 2014;10(3):333–336. https://doi.org/10.2217/fca.14.12.Perez P.M., Bravo S.D., Trigo G., Ruiz de Castroviejo V.E., Torres Llergo J., Lozano Cabezas C., Fernández Guerrero J.C. Resolution of left ventricular thrombus by rivaroxaban. Future Cardiol. 2014;10(3):333–336. https://doi.org/10.2217/fca.14.12.Mano Y., Koide K., Sukegawa H., Kodaira M., Ohki T. Successful resolution of a left ventricular thrombus with apixaban treatment following acute myocardial infarction. Heart Vessels. 2016;31(1):118–123. https://doi.org/10.1007/s00380-014-0562-z.Mano Y., Koide K., Sukegawa H., Kodaira M., Ohki T. Successful resolution of a left ventricular thrombus with apixaban treatment following acute myocardial infarction. Heart Vessels. 2016;31(1):118–123. https://doi.org/10.1007/s00380-014-0562-z.Nakasuka K., Ito S., Noda T., Hasuo T., Sekimoto S., Ohmori H. et al. Resolution of left ventricular thrombus secondary to tachycardia-induced heart failure with rivaroxaban. Case Rep Med. 2014;2014:814524. https://doi.org/10.1155/2014/814524.Nakasuka K., Ito S., Noda T., Hasuo T., Sekimoto S., Ohmori H. et al. Resolution of left ventricular thrombus secondary to tachycardia-induced heart failure with rivaroxaban. Case Rep Med. 2014;2014:814524. https://doi.org/10.1155/2014/814524.Degheim G., Berry A., Zughaib M. Off label use of direct oral anticoagulants for left ventricular thrombus. Is it appropriate? Am J Cardiovasc Dis. 2017;7(5):98–101. Available at: https://pubmed.ncbi.nlm.nih.gov/29181265.Degheim G., Berry A., Zughaib M. Off label use of direct oral anticoagulants for left ventricular thrombus. Is it appropriate? Am J Cardiovasc Dis. 2017;7(5):98–101. Available at: https://pubmed.ncbi.nlm.nih.gov/29181265.Makrides C.A. Resolution of left ventricular postinfarction thrombi in patients undergoing percutaneous coronary intervention using rivaroxaban in addition to dual antiplatelet therapy. BMJ Case Rep. 2016;2016:bcr2016217843. https://doi.org/10.1136/bcr-2016-217843.Makrides C.A. Resolution of left ventricular postinfarction thrombi in patients undergoing percutaneous coronary intervention using rivaroxaban in addition to dual antiplatelet therapy. BMJ Case Rep. 2016;2016:bcr2016217843. https://doi.org/10.1136/bcr-2016-217843.Seecheran R., Seecheran V., Persad S., Seecheran N.A. Rivaroxaban as an antithrombotic agent in a patient with ST-segment elevation myocardial infarction and left ventricular thrombus: a case report. J Investig Med High Impact Case Rep. 2017;5(1):2324709617697991. https://doi.org/10.1177/2324709617697991.Seecheran R., Seecheran V., Persad S., Seecheran N.A. Rivaroxaban as an antithrombotic agent in a patient with ST-segment elevation myocardial infarction and left ventricular thrombus: a case report. J Investig Med High Impact Case Rep. 2017;5(1):2324709617697991. https://doi.org/10.1177/2324709617697991.Tomasoni D., Sciatti E., Bonelli A., Vizzardi E., Metra M. Direct oral anticoagulants for the treatment of left ventricular thrombus – a new indication? A meta-summary of case reports DOACs in left ventricular thrombosis. J Cardiovasc Pharmacol. 2020;75(6):530–534. https://doi.org/10.1097/FJC.0000000000000826.Tomasoni D., Sciatti E., Bonelli A., Vizzardi E., Metra M. Direct oral anticoagulants for the treatment of left ventricular thrombus – a new indication? A meta-summary of case reports DOACs in left ventricular thrombosis. J Cardiovasc Pharmacol. 2020;75(6):530–534. https://doi.org/10.1097/FJC.0000000000000826.Zannad F., Anker S.D., Byra W.M., Cleland J.G.F., Fu M., Gheorghiade M. et al. Rivaroxaban in Patients with Heart Failure, Sinus Rhythm, and Coronary Disease. N Engl J Med. 2018;379(14):1332–1342. https://doi.org/10.1056/NEJMoa1808848.Zannad F., Anker S.D., Byra W.M., Cleland J.G.F., Fu M., Gheorghiade M. et al. Rivaroxaban in Patients with Heart Failure, Sinus Rhythm, and Coronary Disease. N Engl J Med. 2018;379(14):1332–1342. https://doi.org/10.1056/NEJMoa1808848.McDonagh Th., Metra M., Adamo M., Gardner R.S., Baumbach A., Böhm M. et al. Corrigendum to: 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: Developed by the Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC) With the special contribution of the Heart Failure Association (HFA) of the ESC. Eur Heart J. 2021;42(48):4901. https://doi.org/10.1093/eurheartj/ehab368.McDonagh Th., Metra M., Adamo M., Gardner R.S., Baumbach A., Böhm M. et al. Corrigendum to: 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: Developed by the Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC) With the special contribution of the Heart Failure Association (HFA) of the ESC. Eur Heart J. 2021;42(48):4901. https://doi.org/10.1093/eurheartj/ehab368.Mehra M.R., Vaduganathan M., Fu M., Ferreira J.P., Anker S.D., Cleland J.G.F. et al. A comprehensive analysis of the effects of rivaroxaban on stroke or transient ischaemic attack in patients with heart failure, coronary artery disease, and sinus rhythm: the COMMANDER HF trial. Eur Heart J. 2019;40(44):3593–3602. https://doi.org/10.1093/eurheartj/ehz427.Mehra M.R., Vaduganathan M., Fu M., Ferreira J.P., Anker S.D., Cleland J.G.F. et al. A comprehensive analysis of the effects of rivaroxaban on stroke or transient ischaemic attack in patients with heart failure, coronary artery disease, and sinus rhythm: the COMMANDER HF trial. Eur Heart J. 2019;40(44):3593–3602. https://doi.org/10.1093/eurheartj/ehz427.

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