Статья
ВРЕМЕННЫЕ АСПЕКТЫ НАЗНАЧЕНИЯ ИНГИБИТОРОВ P2Y<sub>12</sub> ТРОМБОЦИТОВ В ЛЕЧЕНИИ Больных С ОСТРЫМ КОРОНАРНЫМ СИНДРОМОМ
В последние годы активно обсуждаются вопросы выбора препарата для двухкомпонентной антитромбоцитарной терапии (ДАТТ) у пациентов с острым коронарным синдромом (ОКС), а также сроки и продолжительность применения дезагрегантов. В статье приводятся данные основных рандомизированных исследований с клопидогрелом и новыми ингибиторами P2Y12 - прасугрелом, тикагрелором, кангрелором, оценивающих предварительную тактику назначения дезагрегантов перед проведением коронарографии/чрескожного коронарного вмешательства у пациентов с ОКС. В клиническом обзоре в сравнительном аспекте анализируются различия между рекомендациями Европейского кардиологического общества и рекомендациями Американской коллегии кардиологов/Американской ассоциации сердца по пероральной терапии ингибиторами P2Y12 при ведении пациентов с ОКС.
1. Windecker S., Kolh P., Alfonso F. et al.; Authors/Task Force Members. 2014 ESC/EACTS guidelines on myocardial revascularization: The Task Force on Myocardial Revascularization of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS) developed with the special contribution of the European Association of Percutaneous Cardiovascular Interventions (EAPCI). Eur Heart J 2014;35:2541-2619.
2. The Task Force on the management of ST-segment elevation acute myocardial infarction of the European Society of Cardiology (ESC), Steg P. G., James S. K., Atar D. et al. ESC guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation. Eur Heart J 2012;33:2569-2619.
3. O'Gara P. T., Kushner F. G., Ascheim D. D. et al.; American College of Cardiology Foundation/American Heart Association Task Force on Practice G. 2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation 2013;127: e362-e425.
4. Authors/Task Force Members, Roffi M., Patrono C., Collet J. P. et al. 2015 ESC guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation: 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 2016;37:267-315.
5. Amsterdam E. A., Wenger N. K., Brindis R. G. et al.; American College of Cardiology, American Heart Association Task Force on Practice Guidelines, Society for Cardiovascular Angiography and Interventions, Society of Thoracic Surgeons, American Association for Clinical Chemistry. 2014 AHA/ACC guideline for the management of patients with non-ST-elevation acute coronary syndromes: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol 2014;64: e139 - e228.
6. Sibbing D., Steinhubl S. R., Schulz S. et al. Platelet aggregation and its association with stent thrombosis and bleeding in clopidogrel-treated patients: initial evidence of a therapeutic window. J Am Coll Cardiol 2010;56:317-318.
7. Steinhubl S. R., Berger P. B., Mann J. T. III et al.; CREDO Investigators. Clopidogrel for the Reduction of Events During Observation. Early and sustained dual oral antiplatelet therapy following percutaneous coronary intervention: a randomized controlled trial. JAMA 2002;288:2411-2420.
8. Mehta S. R., Yusuf S., Peters R.J. et al.; Clopidogrel in unstable angina to prevent recurrent events trial I. Effects of pretreatment with clopidogrel and aspirin followed by long-term therapy in patients undergoing percutaneous coronary intervention: the PCI-CURE study. Lancet 2001;358:527-533.
9. Bellemain-Appaix A., Kerneis M., O'Connor S. A. et al., for the ACTION Study Group. Reappraisal of thienopyridine pretreatment in patients with non-ST elevation acute coronary syndrome: a systematic review and meta-analysis. BMJ 2014;349: g6269.
10. Bellemain-Appaix A., O'Connor S. A., Silvain J. et al., ACTION Group. Association of clopidogrel pretreatment with mortality, cardiovascular events, and major bleeding among patients undergoing percutaneous coronary intervention: a systematic review and meta-analysis. JAMA 2012;308:2507-2516.
11. Hollopeter G., Jantzen H. M., Vincent D. et al. Identification of the platelet ADP receptor targeted by antithrombotic drugs. Nature 2001;409:202-207.
12. Savi P., Pereillo J. M., Uzabiaga M. F. et al. Identification and biological activity of the active metabolite of clopidogrel. Thromb Haemost 2000;84:891-896.
13. Aradi D., Kirtane A., Bonello L. et al. Bleeding and stent thrombosis on P2Y12-inhibitors: collaborative analysis on the role of platelet reactivity for risk stratification after percutaneous coronary intervention. Eur Heart J 2015;36:1762-1771.
14. Muller I., Seyfarth M., Rudiger S. et al. Effect of a high loading dose of clopidogrel on platelet function in patients undergoing coronary stent placement. Heart 2001;85:92-93.
15. Kastrati A., von Beckerath N., Joost A. et al. Loading with 600 mg clopidogrel in patients with coronary artery disease with and without chronic clopidogrel therapy. Circulation 2004;110:1916-1919.
16. von Beckerath N., Taubert D., Pogatsa-Murray G. et al. Absorption, metabolization, and antiplatelet effects of 300-, 600-, and 900-mg loading doses of clopidogrel: results of the ISAR-CHOICE (Intracoronary Stenting and Antithrombotic Regimen: Choose Between 3 High Oral Doses for Immediate Clopidogrel Effect) Trial. Circulation 2005;112:2946-2950.
17. Sabatine M. S., Cannon C. P., Gibson C. M. et al.; Clopidogrel as Adjunctive Reperfusion Therapy (CLARITY) - Thrombolysis in Myocardial Infarction (TIMI) Investigators. Effect of clopidogrel pretreatment before percutaneous coronary intervention in patients with ST-elevation myocardial infarction treated with fibrinolytics: the PCI-CLARITY study. JAMA 2005;294:1224-1232.
18. Sabatine M. S., Cannon C. P., Gibson C. M. et al., CLARITY-TIMI Investigators. Addition of clopidogrel to aspirin and fibrinolytic therapy for myocardial infarction with ST-segment elevation. N Engl J Med 2005;352:1179-1189.
19. Yusuf S., Zhao F., Mehta S. R. et al. Clopidogrel in Unstable Angina to Prevent Recurrent Events Trial I. Effects of clopidogrel in addition to aspirin in patients with acute coronary syndromes without ST-segment elevation. N Engl J Med 2001;345:494-502.
20. von Beckerath N., Taubert D., Pogatsa-Murray G. et al. Absorption, metabolization, and antiplatelet effects of 300-, 600-, and 900-mg loading doses of clopidogrel: results of the ISAR-CHOICE (Intracoronary Stenting and Antithrombotic Regimen: Choose Between 3 High Oral Doses for Immediate Clopidogrel Effect) Trial. Circulation 2005;112:2946-2950.
21. Kastrati A., Mehilli J., Neumann F.J. et al. Abciximab in patients with acute coronary syndromes undergoing percutaneous coronary intervention after clopidogrel pretreatment: the ISAR-REACT 2 randomized trial. JAMA 2006;295:1531-1538.
22. Kastrati A., Neumann F.J., Schulz S. et al.; ISAR-REACT Trial Investigators. Abciximab and heparin versus bivalirudin for non-ST-elevation myocardial infarction. N Engl J Med 2011;365:1980-1989.
23. Wiviott S. D., Braunwald E., McCabe C. H. et al. Prasugrel versus clopidogrel in patients with acute coronary syndromes. N Engl J Med 2007;357:2001-2015.
24. Montalescot G., Bolognese L., Dudek D. et al.; for the ACCOAST Investigators. Pretreatment with prasugrel in non-ST-segment elevation acute coronary syndromes. N Engl J Med 2013;369:999-1010.
25. Widimsky P., Motovska Z., Bolognese L. et al., the ACCOAST Investigators. Predictors of bleeding in patients with acute coronary syndromes treated with prasugrel. Heart 2015;101:1219-1224.
26. Bonello L., Laine M., Cluzel M. et al. Comparison of ticagrelor versus prasugrel to prevent periprocedural myonecrosis in acute coronary syndromes. Am J Cardiol 2015;116:339-343.
27. De Backer O., Ratcovich H., Biasco L. et al. Prehospital administration of P2Y12 inhibitors and early coronary reperfusion in primary PCI: a non-randomized comparative study. Thromb Haemost 2015;114:623-631.
28. Schulz S., Angiolillo D.J., Antoniucci D. et al. Randomized comparison of ticagrelor versus prasugrel in patients with acute coronary syndrome and planned invasive strategy-design and rationale of the Intracoronary Stenting and Antithrombotic Regimen: Rapid Early Action for Coronary Treatment (ISAR-REACT) 5 trial. J Cardiovasc Transl Res 2014;7:91-100.
29. Wallentin L., Becker R. C., Budaj A. et al., for the PLATO Investigators, Freij A, Thorsen M. Ticagrelor versus clopidogrel in patients with acute coronary syndromes. N Engl J Med 2009;361:1045-1057.
30. Montalescot G., van't Hof A. W., Lapostolle F. et al., ATLANTIC Investigators. Prehospital ticagrelor in ST-segment elevation myocardial infarction. N Engl J Med 2014;371:1016-1027.
31. Kubica J., Adamski P., Ostrowska M. et al. Influence of Morphine on Pharmacokinetics and Pharmacodynamics of Ticagrelor in Patients with Acute Myocardial Infarction (IMPRESSION): study protocol for a randomized controlled trial. Trials 2015;16:198.
32. Mauri L., Kereiakes D.J., Yeh R. W. et al., the DAPT Study Investigators. Twelve or 30 months of dual antiplatelet therapy after drug-eluting stents. N Engl J Med 2014;371:2155-2166.
33. Bhatt D. L., Lincoff A. M., Gibson C. M. et al. Intravenous platelet blockade with cangrelor during PCI. N Engl J Med 2009;361:2330-2341.
34. Bhatt D. L., Stone G. W., Mahaffey K. W. et al., CHAMPION PHOENIX Investigators. Effect of platelet inhibition with cangrelor during PCI on ischemic events. N Engl J Med 2013;368:1303-1313.
35. Harrington R. A., Stone G. W., McNulty S. et al. Platelet inhibition with cangrelor in patients undergoing PCI. N Engl J Med 2009;361: 2318-2329.
36. Thygesen K., Alpert J. S., Jaffe A. S. et al. the Writing Group on behalf of the Joint ESC/ACCF/AHA/WHF Task Force for the Universal Definition of Myocardial Infarction. Third universal definition of myocardial infarction. European Heart Journal (2012) 33, 2551-2567. DOI:10.1093/eurheartj/ehs184