Прогрессирующий ишемический инсульт: проблема выбора антитромботической терапии

Evgenii A. Shirokov1, Nikita V. Lomakin2, Luydmila I. Buryachkovskaya3
1ФГБВОУ «Военно-медицинская академия им. С.М. Кирова» (Московский филиал), Москва, Россия; 2ФГБУ «Центральная клиническая больница с поликлиникой» Управления делами Президента РФ, Москва, Россия; 3Институт экспериментальной кардиологии ФГБУ «Национальный медицинский исследовательский центр кардиологии» МЗ РФ, Москва, Россия

Аннотация


Прогрессирующий ишемический инсульт — клинический вариант неблагоприятного течения острого нарушения мозгового кровообращения, который обнаруживается примерно в 20% случаев в остром периоде заболевания. Стратегия и тактика ведения больных с явным ухудшением в остром периоде инсульта окончательно не определены. В литературных источниках обсуждаются разные направления антитромботической терапии, среди которых применение антитромбоцитарных препаратов считается наиболее перспективным.

Авторы статьи анализируют все направления антитромботической терапии при прогрессирующем ишемическом инсульте и детально рассматривают единственный известный случай позднего тромболизиса, который был выполнен в 1968 г.

Литература

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Kernan W.N., Obliagele B., Black H.R. et al. Guidelines for the prevention of stroke in patients with stroke and transient ischemic attack: a guideline for healthcare professionals from the American Heart Association/American Stroke Asso- ciation. Stroke 2014; 45: 2160–2236. DOI: 10.1161/STR.0000000000000024. PMID: 24788967.
Powers W.J., Rabinstein A.A., Ackerson T. et al. Guidelines for the early man- agement of patients with acute ischemic stroke: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke 2018; 49: e46–e110. DOI: 10.1161/ STR.0000000000000158. PMID: 29367334.
Campbell B.C.V., Meretoja A., Donnan G.A., Davis S.M. Twenty-year history of the evolution of stroke thrombolysis with intravenous alteplase to reduce long-term disability. Stroke 2015; 46: 2341–2346. DOI: 10.1161/STROKEA- HA.114.007564. PMID: 26152294.
Muruet W., Rudd A., Wolfe C.D.A., Douiri A. Long-term survival after in- travenous thrombolysis for ischemic stroke. A propensity score-matched co- hort with up to 10-year follow-up. Stroke 2018; 49: 607–613. DOI: 10.1161/ STROKEAHA.117.019889. PMID: 29440582.
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Emberson J., Lees K.R., Lyden P. et al. Effect of treatment delay, age, and stroke severity on the effects of intravenous thrombolysis with alteplase for acute ischaemic stroke: a meta-analysis of individual patient data from randomised trials. Lancet 2014; 384: 1929–1935. DOI: 10.1016/S0140-6736(14)60584-5. PMID: 25106063.
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Ключевые слова

ишемический инсульт; прогрессирующий стволовой ишемический инсульт; острый период ишемического инсульта; антитромботическая терапия; тромбоз; тромболизис; активаторы плазминогена; фибринолизин; антикоагулянты; антиагреганты

Полный текст:

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Литература

Chimowitz M.I. The Feinberg award lecture 2013: treatment of intracranial atherosclerosis: leaning from the past and planning for the future. Stroke 2013; 44: 2664–2669. DOI: 10.1161/STROKEAHA.113.001290. PMID: 23821232.

Amarenco P., Lavallee P.C., Tavares L.M. et al. Five-year risk of stroke af- ter TIA or minor ischemic stroke. N Engl J Med 2018; 378: 2182–2190. DOI: 10.1056/NEJMoa1802712. PMID: 29766771.

Yang W., Wong K., Chen X. Intracranial atherosclerosis: from microscopy to high-resolution Magnetic Resonance Imaging. J Stroke 2017; 19: 249–260. DOI: 10.5853/jos.2016.01956. PMID: 28877564.

Kernan W.N., Obliagele B., Black H.R. et al. Guidelines for the prevention of stroke in patients with stroke and transient ischemic attack: a guideline for health- care professionals from the American Heart Association/American Stroke Asso- ciation. Stroke 2014; 45: 2160–2236. DOI: 10.1161/STR.0000000000000024. PMID: 24788967.

Powers W.J., Rabinstein A.A., Ackerson T. et al. Guidelines for the early man- agement of patients with acute ischemic stroke: a guideline for healthcare pro- fessionals from the American Heart Association/American Stroke Association. Stroke 2018; 49: e46–e110. DOI: 10.1161/ STR.0000000000000158. PMID: 29367334.

Campbell B.C.V., Meretoja A., Donnan G.A., Davis S.M. Twenty-year his- tory of the evolution of stroke thrombolysis with intravenous alteplase to reduce long-term disability. Stroke 2015; 46: 2341–2346. DOI: 10.1161/STROKEA- HA.114.007564. PMID: 26152294.

Muruet W., Rudd A., Wolfe C.D.A., Douiri A. Long-term survival after in- travenous thrombolysis for ischemic stroke. A propensity score-matched co- hort with up to 10-year follow-up. Stroke 2018; 49: 607–613. DOI: 10.1161/ STROKEAHA.117.019889. PMID: 29440582.

Ali L.K., Saver J.L. The ischemic stroke patient who worsens: new assessment and management approaches. Rev Neurol Dis 2007; 4: 85–91. PMID: 17609640.

Lesser T., Venth S., Lesser K. Progressive stroke in cases of common carotid occlusion — indication for revascularization. Zentralbl Chir 2008; 133: 374–375. DOI: 10.1055/s-2008-1076905. PMID: 18702024.

Birschel P., Ellul J., Barer D. Progressing stroke: towards an internationally agreed definition. Cerebrovasc Dis 2004; 17: 242–252. DOI: 10.1159/000076161. PMID: 14718754.

Emberson J., Lees K.R., Lyden P. et al. Effect of treatment delay, age, and stroke severity on the effects of intravenous thrombolysis with alteplase for acute ischaemic stroke: a meta-analysis of individual patient data from randomised trials. Lancet 2014; 384: 1929–1935. DOI: 10.1016/S0140-6736(14)60584-5. PMID: 25106063.

Fiehler J., Cognard C., Gallitelli M. et al. European Recommendations on Organisation of Interventional Care in Acute Stroke (EROICAS). Int J Stroke 2016; 11: 701–716. DOI: 10.1177/1747493016647735. PMID: 27462090.

Nakase T., Sasaki M., Ikeda Y., Suzuki A. Progressing small vessel pontine infarction includes different etiologies. Ann Clin Transl Neurol 2014; 1: 75–79. DOI: 10.1002/acn3.25. PMID: 25356386.

Cho Y.J., Koo J.S., Park J.M. et al. Factors associated with stroke progression in acute cerebral infarction. Int J Stroke 2008; 3: 405.

Castillo J., Noya M. Mechanisms of progression of cerebral infarction. Neu- rologia 1999; 14: 2–12. PMID: 10379155.

Milstone H. A factor in human normal blood which participates in strepto- coccal fibrinolysis. J Immunology 1941; 42: 109–115.

Kline D.L. The purification and crystallization of plasminogen (profibrino- lysin). J Biol Chem 1953; 204: 949–955. PMID: 13117872.

Sussman B.J., Fitch T.S. Thrombolysis with fibrinolysin in cere- bral arterial occlusion. JAMA 1958; 167: 1705–1709. DOI: 10.1001/ jama.1958.02990310011002. PMID: 13563167.

Meyer J.S., Gilroy J., Barnhart M.I., Johnson J.F. Anticoagulants plus strep- tokinase therapy in progressive stroke. JAMA 1964; 189: 373. DOI: 10.1001/ jama.1964.03070050039011. PMID: 14163124.

Schefer D.G., Chorjakov G.I. [The first experience of using fibrinolysin in an ambulance]. Vsesoyuznyy simpozium “Preduprezhdeniye i lecheniye mozgovykh insul’tov” Moscow, 1965: 34–35. (In Russ.)

Chazov E.I., Andreyenko G.V. [The first experience of thrombosis therapy with domestic fibrinolysin]. Kardiologiya 1962; 4: 59–64. (In Russ.)

Andreyenko G.V. [Fibrinolysis]. Moscow, 1967. 248 p. (In Russ.)

Mustard J.F., Murphy E.A., Downie H.G., Rowsell H.C. Heparin and thrombus formation: early suppression and late enhancement. Brit J Haematol 1963; 9: 548–551. DOI: 10.1111/j.1365-2141.1963.tb05479.x. PMID: 14076136.

Kudrjashov B.A. [Biological problems of regulation of the liquid state of blood and its coagulation]. Moscow, 1975. 488 p. (In Russ.)

Rödén-Jüllig A., Britton M. Effectiveness of heparin treatment for progress- ing ischemic stroke: before and after study. J Intern Med 2000; 248: 287–291. DOI: 10.1046/j.1365-2796.2000.00727.x. PMID: 11086638.

Ma H., Campbell H., Parsons M. et al. Thrombolysis guided by perfusion imaging up to 9 hours after onset of stroke. N Engl J Med 2019; 380: 1795–1803. DOI: 10.1056/NEJMoa1813046. PMID: 31067369.

Kate M., Wannamaker R., Kamble H. et al. Penumbral imaging-based thrombolysis with tenecteplase is feasible up to 24 hours after symptom onset. J Stroke 2018; 20: 122–130. DOI: 10.5853/jos.2017.00178. PMID: 29402060.

Hart R.G., Sharma M., Mundl H. et al. Rivaroxaban for stroke prevention af- ter embolic stroke of undetermined source. N Engl J Med 2018; 378: 2191–2201. DOI: 10.1056/NEJMoa1802686. PMID: 29766772.

Berberich A., Schneider C., Reiff T. et al. Dual antiplatelet therapy improves functional outcome in patients with progressive lacunar strokes. Stroke 2019; 50: 1007–1009. DOI: 10.1161/STROKEAHA.118.023789. PMID: 30841818.




DOI: http://dx.doi.org/10.25692/ACEN.2020.3.5