Terapevticheskii arkhivTerapevticheskii arkhivТерапевтический архив0040-36602309-5342LLC Obyedinennaya Redaktsiya3366310.26442/00403660.2019.08.000355Editorial articleПередовая статьяReview ArticleThe relationship between the combined use of various proton pump inhibitors with antiplatelet drugs and the risk of cardiovascular complicationsВзаимосвязь между сочетанным применением различных представителей класса ингибиторов протонной помпы с антитромбоцитарными препаратами и риском сердечно - сосудистых осложненийOstroumovaO DОстроумоваОльга Дмитриевна

д.м.н., проф., зав. лаб. клинической фармакологии и фармакотерапии ФГБОУ ВО «РНИМУ им. Н.И. Пирогова» - ОСП «Российский геронтологический научно-клинический центр»; проф. каф. клинической фармакологии и пропедевтики внутренних болезней ФГАОУ ВО «Первый МГМУ им. И.М. Сеченова»; ORCID: 0000-0002-0795-8225

ostroumova.olga@mail.ruKochetkovA IКочетковАлексей Иванович

к.м.н., н.с. лаб. клинической фармакологии и фармакотерапии ФГБОУ ВО «РНИМУ им. Н. И. Пирогова» - ОСП «Российский геронтологический научно-клинический центр»; ORCID: 0000-0001-5801-3742

PereverzevA PПереверзевАнтон Павлович

к.м.н., н.с. лаб. клинической фармакологии и фармакотерапии ФГБОУ ВО «РНИМУ им. Н. И. Пирогова» - ОСП «Российский геронтологический научно-клинический центр»; ORCID: 0000-0001-7168-3636

KravchenkoE VКравченкоЕвгений Владимирович

студент 4-го курса лечебного факультета ФГБОУ ВО «МГМСУ им. А.И. Евдокимова»; ORCID: 0000-0001-8551-1421

KazjulinA NКазюлинАлександр Нисонович

проф., д.м.н., проф. каф. пропедевтики внутренних болезней и гастроэнтерологии ФГБОУ ВО «МГМСУ им. А.И. Евдокимова»

AndreevD NАндреевДмитрий Николаевич

к.м.н., доц. каф. пропедевтики внутренних болезней и гастроэнтерологии ФГБОУ ВО «МГМСУ им. А.И. Евдокимова»

PavleevaE EПавлееваЕлена Евгеньевна

к.м.н., ассистент каф. пропедевтики внутренних болезней и гастроэнтерологии ФГБОУ ВО «МГМСУ им. А.И. Евдокимова»

Pirogov Russian National Research Medical University - Russian Clinical and Research Center of GerontologyФГБОУ ВО «Российский научно-исследовательский медицинский университет им. Н. И. Пирогова» Минздрава России - ОСП «Российский геронтологический научно-клинический центр»Sechenov First Moscow State Medical University (Sechenov University)ФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова» Минздрава России (Сеченовский Университет)Yevdokimov Moscow State University of Medicine and DentistryФГБОУ ВО «Московский государственный медико-стоматологический университет им. А.И. Евдокимова» Минздрава Россииru150820192019918VOL 91, NO8 (2019)ТОМ 91, №8 (2019)11812616042020Received:16042020Published:15082019Copyright ©; 2019, Consilium MedicumCopyright ©; 2019, ООО "Консилиум Медикум"2019Consilium MedicumООО "Консилиум Медикум"https://creativecommons.org/licenses/by-nc-sa/4.0https://ter-arkhiv.ru/0040-3660/article/view/33663

In the article the problem of the combined use of clopidogrel and various proton pump inhibitors (PPIs) in terms of cardiovascular complications risk and stent thrombosis is considered. The results of meta - analyses and a systematic reviews affecting this issue are represented in detail. The inter - drug interactions mechanisms of various PPIs with clopidogrel based on the characteristics of the metabolism in the liver cytochromes system are discussed. The authors conducted a search, systematization and analysis of studies regarding the association between cardiovascular risk and combined use of individual medications from PPI class with clopidogrel, and these results are presented in the review. Currently available data do not allow to answer the question about the differences between individual PPIs in their impact on the risk of adverse cardiovascular events due to the small number of such studies, design heterogeneity, differences in the inclusion criteria and end points as well as in the rate of administration of individual PPIs.

В статье рассматривается проблема сочетанного применения клопидогрела и различных представителей класса ингибиторов протонной помпы (ИПП) с точки зрения влияния такой терапии на риск сердечно - сосудистых осложнений и тромбоз стентов. Детально рассмотрены результаты метаанализов и систематических обзоров, затрагивающих данный вопрос. Приведены механизмы межлекарственного взаимодействия различных ингибиторов протонной помпы с клопидогрелом исходя из особенностей метаболизма в системе цитохромов печени. Авторами проведены поиск, систематизация и анализ исследований, в которых изучалась взаимосвязь между сердечно - сосудистым риском и совместным использованием отдельных представителей ингибиторов протонной помпы с клопидогрелом, результаты которого представлены в данном обзоре. Имеющиеся на сегодняшний день данные не позволяют дать ответ на вопрос о различиях между отдельными представителями класса ИПП по влиянию на риск развития неблагоприятных сердечно - сосудистых событий в связи с небольшим количеством подобных исследований, гетерогенностью их дизайна, различиями в контингенте включенных пациентов, в определении конечных точек и в частоте назначения конкретных представителей класса ИПП.

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