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Actual Issues of Ischemic and Hemorrhagic Events Risk Management During Antithrombotic Therapy in Patients with Acute Coronary Syndrome

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Today, optimal duration of double antiplatelet (DAPT) and triple antithrombotic therapy (TATT) in patients with acute coronary syndrome (ACS) remains the subject of scientific and practical discussion on possibilities of ischemic and hemorrhagic risks assessment. Good clinical risk metrics is based on validated risk scales. However, actual clinical guidelines do not provide a universal and generally accepted scale for assessing the balance of risks of ischemic events and bleeding. Is very necessary to determine the optimal content and DAPT or TATT duration is the existence of validated risk assessment scales would allow to optimize the accuracy of risk assessment of ischemic and hemorrhagic events in patients after ACS. One of the probable reasons is absence of validation of existing scales for each specific population of patients with ACS. In this regard, the use of «new» risk assessment systems: PRECISE DAPT and DAPT, in addition to the routine risk assessment scales (GRACE, CRUSADE), could become optimal in all ACS patient categories. In order to identify the initial risk of community-acquired hemorrhagic events during the first 12 months all patients with ACS at the inpatient stage of treatment is used the PRECISE DAPT score. In order to determine the need for prolongation of the standard DAPT. It should be used after 12 months of receiving DAPT in survivors of ACS patients without ischemic events, must be used the DAPT score.

About the Authors

R. M. Velieva
Research Institute for Complex Issues of Cardiovascular Diseases
Russian Federation

Velieva Rufana Mamed Kyzy - MD, Postgraduate Student, Cardiologist, Research Institute for Complex Issues of Cardiovascular Diseases.
Sosnoviy bulv. 6, Kemerovo, 650002.

T. B. Pecherina
Research Institute for Complex Issues of Cardiovascular Diseases
Russian Federation

Pecherina Tamara Borzalievna - MD, PhD, Senior Researcher, Laboratory of Pathophysiology of Multifocal Atherosclerosis; Senior Lecturer, Scientific and Educational Department, Research Institute for Complex Issues of Cardiovascular Diseases.
Sosnoviy bulv. 6, Kemerovo, 650002.

A. S. Vorobiev
Surgut State University
Russian Federation

Vorobyov Anton Sergeevich - MD, PhD, Leading Researcher, Scientific and Educational Department; Associate Professor, Cardiology Chair, Medical Institute, Surgut State University.
Lenina pr. 1, Surgut, 628403.

V. V. Kashtalap
Research Institute for Complex Issues of Cardiovascular Diseases
Russian Federation

Kashtalap Vasily Vasilievich - MD, Head of the Laboratory of Pathophysiology of Multifocal Atherosclerosis, Research Institute for Complex Issues of Cardiovascular Diseases.
Sosnoviy bulv. 6, Kemerovo, 650002.

D. Yu. Sedykh
Research Institute for Complex Issues of Cardiovascular Diseases
Russian Federation

Sedykh Daria Yuryevna - MD, PhD, Researcher, Laboratory of Pathophysiology laboratory of multifocal atherosclerosis, Research Institute for Complex Issues of Cardiovascular Diseases
Sosnoviy bulv. 6, Kemerovo, 650002.


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For citation:

Velieva R.M., Pecherina T.B., Vorobiev A.S., Kashtalap V.V., Sedykh D.Yu. Actual Issues of Ischemic and Hemorrhagic Events Risk Management During Antithrombotic Therapy in Patients with Acute Coronary Syndrome. Rational Pharmacotherapy in Cardiology. 2020;16(6):1024-1030. (In Russ.)

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