References

medsovet

Медицинский Совет

Meditsinskiy sovet = Medical Council

2079-701X2658-5790

REMEDIUM GROUP Ltd.

10.21518/ms2023-459

medsovet-8007

Research Article

НЕВРОЛОГИЯ

NEUROLOGY

Антитромбоцитарная терапия в профилактике повторного ишемического инсульта

Antiplatelet therapy in the prevention of recurrent ischemic stroke

https://orcid.org/0000-0002-7465-0677

Пизова

Н. В.

Pizova

N. V.

Пизова Наталья Вячеславовна - д.м.н., профессор кафедры нервных болезней с медицинской генетикой и нейрохирургией.

150000, Ярославль, ул. Революционная, д. 5

Nataliia V. Pizova - Dr. Sci. (Med.), Professor of the Department of Nervous Diseases with Medical Genetics and Neurosurgery.

5, Revolutsionnaya St., Yaroslavl, 150000

pizova@yandex.ru

Ярославский государственный медицинский университетРоссияYaroslavl State Medical UniversityRussian Federation

2023

19012024

02398104

2024

Пизова Н.В.

Pizova N.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/8007

Инсульт, включая ишемические и геморрагические события, является значимой причиной среди всех смертей во всем мире. В настоящее время это наиболее распространенная причина инвалидности. В нелеченых случаях с недавним инсультом или транзиторной ишемической атакой риск рецидива является самым высоким. Повторный инсульт встречается примерно в 30% случаев, приводя к ухудшению неврологической симптоматики или даже летальному исходу. Поэтому первичная профилактика первого инсульта и вторичная профилактика повторного инсульта являются первоочередной задачей. Первичная профилактика ишемического инсульта включает модификацию образа жизни и диеты, лечение факторов риска, включая артериальную гипертензию, сахарный диабет и нарушения липидного обмена, антитромбоцитарную терапию для пациентов с высоким сосудистым риском и антикоагулянтную терапию при фибрилляции предсердий. Вторичная профилактика ишемического инсульта включает в себя дополнительно операцию на сонной артерии у симптомных пациентов. До 90% всех инсультов можно предотвратить, и они связаны с основными модифицируемыми факторами риска. Оптимальная профилактика инсульта требует гармоничного, комплексного подхода к просвещению о риске инсульта и здоровом образе жизни, простого скрининга и ведения пациентов на предмет наличия в анамнезе модифицируемых и поддающихся лечению причинных факторов риска, а также улучшения социальных и экологических факторов. Прогноз пациентов после перенесенного ишемического инсульта или транзиторной ишемической атаки улучшается при приеме антиагрегантов в зависимости от подтипа. Изучение современных данных о рецидиве инсульта и смертности важны для изучения тенденций, факторов риска и эффектов лечения.

Stroke that includes both ischemic and hemorrhagic events is a major cause of death worldwide. It is currently the most common cause of disability. The risk of recurrence is the highest among cases where a recent stroke or transient ischemic attack was left untreated. In about 30% of these cases, a recurrent stroke leads to the worsening neurological symptoms or even death. Therefore, primary prevention of first stroke and secondary prevention of recurrent stroke are a top priority. Primary prevention of ischemic stroke includes lifestyle modification and diets, treatment of risk factors including hypertension, diabetes mellitus and lipid disorders, antiplatelet therapy for high vascular risk patients, and anticoagulation therapy in atrial fibrillation. Secondary prevention of ischemic stroke includes additional carotid surgery in symptomatic patients. Up to 90% of all strokes are preventable, and attributable to major modifiable risk factors. Optimal stroke prevention requires a harmonious, integrated approach to educating about stroke risk and healthy lifestyle, simple screening and management of patients for a history and presence of modifiable and treatable causal risk factors, and improving social and environmental factors. Intake of antiplatelet agents according to the subtype improves the prognosis of patients after an ischemic stroke or transient ischemic attack. Current data on stroke recurrence and mortality are important to examine trends, risk factors, and treatment effects.

ишемический инсультриск повторного инсультамодифицируемые и немодифицируемые факторы рискаантитромбоцитарная терапия

ischemic strokerisk of recurrent strokemodifiable and unmodified risk factorsantiplatelet therapy

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