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Ацетилсалициловая кислота в первичной и вторичной профилактике сердечно-сосудистых заболеваний. Все ли очевидно?

https://doi.org/10.21518/2079-701X-2015-12-66-71

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Аннотация

В обзоре приводятся данные о результатах клинических исследований и метаанализов, свидетельствующих об эффективности ацетилсалициловой кислоты (АСК) при вторичной профилактике сердечнососудистых заболеваний - улучшении прогноза больных, перенесших инфаркт миокарда (ИМ), инсульт или транзиторную ишемическую атаку (ТИА), лиц с текущим ОИМ, инсультом и стабильной ИБС. Снижение риска наиболее существенно для нефатальных событий и менее значимо для сердечно-сосудистой смертности. Вместе с тем предметом дискуссии до настоящего времени остаются показания для использования препаратов АСК у лиц без установленной сердечно-сосудистой патологии, поскольку трактовка имеющихся данных об эффекте АСК при первичной профилактике достаточно сложна, а при длительном приеме препарата существует риск развития геморрагических осложнений. Приводятся рекомендации рабочей группы по тромбозу Европейского общества кардиологов и Американской диабетической ассоциации, в которых применение АСК для первичной профилактики считается обоснованным лишь у больных с высоким кардиоваскулярным риском. Обсуждаются вопросы безопасности при терапии аСк и возможности профилактики желудочно-кишечных кровотечений.

Об авторах

А. В. Панов
Северо-Западный Федеральный медицинский исследовательский центр им. В.А. Алмазова, Санкт-Петербург
Россия


Э. В. Кулешова
Северо-Западный Федеральный медицинский исследовательский центр им. В.А. Алмазова, Санкт-Петербург
Россия


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