FEATURES OF TREATMENT WITH ANTITHROMBOTIC AND ANTICOAGULANT DRUGS IN PATIENTS WITH ACUTE CORONARY SYNDROME WITHOUT ST SEGMENT ELEVATION
Keywords:
antithrombotic drugs, anticoagulants, acute coronary syndrome, anemia, bleedingAbstract
Combined treatment with antiaggregants and anticoagulants may constitute a scheduling approach for the treatment of intense coronary disorder without ST fragment height (AC-ST) in patients with a lack of iron deficiency. However, a few of these patients are at high risk of hemorrhagic complications. This work highlights the importance of choosing the restorative procedure for such patients. The review examination of therapeutic cards of 112 patients alluded to the Office of Cardiac Activity with Determination of AC-ST included the estimation of the adequacy and safety of the anticoagulant heparin in the treatment of press insufficiency iron deficiency in terms of the recurrence of thrombotic and hemorrhagic complications and a guess of the result compared with the patients given no anticoagulants. A total of 35 patients were included. Antithrombotic treatment ought to be endorsed for such patients, taking into account the chance of thrombotic complications. The possibility of stall rot loss and frailty in patients with CS-STs requires illustration and evaluation of hemorrhage risk variables (HAS-BLenn scale), the latter of which determine the choice of modality for encouraging treatment.
References
Alexander K. Р., Peterson E. D. Minimizing the risks of anticoagulants and platelet inhibitors. Circulation 2010; 121 (17): 1960—1970.
Anand I., McMurray J. J., Whitmore J. Anemia and its relationship to clinical outcome in heart failure. Circulation 2014; 110: 149—154.
Eikelboom J. W., Mehta S. R., Anand S. S. et al. impact of bleeding on prognosis in patients with acute coronary syndromes. Circulation 2016; 114: 774—782.
Fragmin during Instability in Coronary Artery Disease (FRISC) study group. Low-molecular-weight heparin during instability in coronary artery disease. Lancet 1996; 347 (9001): 561—568.
Ix J. H., de Boer I. H., Wassel C. L. et al. Urinary creatinine excretion rate and mortality in persons with coronary artery disease: the Heart and Soul Study. Circulation 2020; 121 (11): 1295—1303.
Lagerqvist В., Kontny F. 5-year outcomes in the FRISC-II randomised trial of an invasive versus a non-invasive strategy in non-ST-elevation acute coronary syndrome: a follow-up study. Lancet 2016; 368: 998—1004.
Meneveau N., Schiele F., Seronde M. F. et al. Anemia for risk assessment of patients with acute coronary syndromes. Am. J. Cardiol. 2019; 103 (4): 442—447.
Musted S. Evidence-based prescribing and adherence to antiplatelet therapy-how much difference do they make to patients with atherothrombosis? Int. J. Cardiol. 2019; 134 (2): 150—159.
Nancy M., La Pointe A., Pharm D. et al. Enoxaparin dosing and associated risk of in-hospital bleeding and death in patients with non ST-segment elevation acute coronary syndromes. Arch. Internj. Med. 2017; 167 (14): 1539—1544.
Oler A., Whooley M. A., Oler J., Grady D. Adding heparin to aspirin reduces the incidence of myocardial infarction and death in patients with unstable angi-na. A meta-analysis. J.A.M.A. 1996; 276:811—815.
Subherwal S., Bach R. G., Chen A. Y. et al. Baseline risk of major bleeding in non-ST-segment-elevation myocardial infarction: the CRUSADE (Can Rapid risk stratification of Unstable angina patients Suppress AD verse outcomes with Early implementation of the ACC/AHA Guidelines) Bleeding Score. Circulation 2019; 119 (14): 1873—1882.
Yang X., Alexander K. P., Chen A. Y. CRUSADE Investigators. The implications of blood transfusions for patients with non-ST segment elevation acute coronary syndromes: results from the CRUSADE National Quality Improvement Initiative. J. Am. Coll. Cardiol. 2015; 46: 1490—1495.
Van der Hulst R. W., Zandstra D. F., Geraedts A. A. et al. Prevalence of Helicobacter pylori infection in stress-induced gastric mucosal injury. Intensive Care Med. 2011; 27 (1): 68—73.
