Therapeutic aspects of the choice of antithrombotic therapy in patients with multifocal lesions of peripheral arteries


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Abstract

The article discusses the features of the development and course of the atherosclerotic process in various vascular basins. Variability of factors such as local hemodynamics, differences in the structure of the arteries can influence the formation of atherosclerotic plaque and the progression of the atherosclerotic process. A better understanding of the nature and causes of these differences can help improve the tactics of treatment and prevention of vascular complications. Analysis of the results of the COMPASS study (cardiovascular outomes for people using anticoagulation stategies - evaluation of cardiovascular outcomes in patients receiving anticoagulant therapy) showed for the first time the effectiveness of combination therapy using rivaroxaban direct anticoagulant at a dose of 2.5 mg 2 times a day in combination with acetylsalicylic acid at a dose of 100 mg per day. It was shown that, against the background of combination therapy, patients with coronary heart disease or atherosclerotic peripheral artery disease showed a significant decrease in the incidence of events of the primary end point of efficacy: a reduced risk of stroke, cardiovascular mortality and myocardial infarction, and also a reduction in the risk of major lower amputations extremities and total mortality in patients with stable forms of atherosclerosis. The emergence of combination therapy can help to achieve both an improvement in the overall prognosis and the prognosis of limb preservation in patients with multifocal arterial lesion.

About the authors

O Sh Oynotkinova

Lomonosov Moscow State University; Research Institute of the Organization of Health Care and Medical Management; Pirogov National Research Medical University; Central Medical Academy of Administration of the President of the Russian Federation

Email: olga-oynotkinova@yandex.ru
д.м.н., проф., фак-т фундаментальной медицины ФГБОУ ВО «МГУ им. М.В. Ломоносова»; проф. ФГБУ ВПО «РНИМУ им. Н.И. Пирогова»; нач. отд. ГБУ НИИ организации здравоохранения и медицинского менеджмента Департамента здравоохранения г. Москвы Moscow, Russia

E L Nikonov

Pirogov National Research Medical University

д.м.н, проф., зав. каф. ФГБУ ВПО «РНИМУ им. Н.И. Пирогова» Минздрава России Moscow, Russia

E V Kryukov

Burdenko Main Military Clinical Hospital

д.м.н., проф., чл.-кор. РАН, нач. ФГБУ «Главный военный клинический госпиталь им. Н.Н. Бурденко» Минобороны России Moscow, Russia

A P Baranov

Lomonosov Moscow State University; Pirogov National Research Medical University

д.м.н, проф., зав. каф. терапии фак-та фундаментальной медицины ФГБОУ ВО «МГУ им. М.В. Ломоносова» Moscow, Russia

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