Fomin V V, Svistunov A A, Napalkov D A, Sokolova A A, Skripka A I, Morina N A, Fedorova E A
I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia, Moscow, Russia.
Ter Arkh. 2017;89(12):4-9. doi: 10.17116/terarkh201789124-9.
The paper gives an overview of the European Society of Cardiology (ESC) guidelines updated in 2017. The revised and amended guidelines for areas, such as dual antiplatelet therapy (DAT), treatment of patients with ST-segment elevation myocardial infarction (STEMI), and management of patients with valvular heart disease and peripheral artery disease, were presented in late summer of this year. The authors of this paper present an independent analysis and discussion of new data on the key issues of diagnosis and treatment in patients in the above areas. The recommendations on DAT pay special attention to the timing of the therapy and to the choice of its drugs. The updated data on the treatment of patients with STEMI accurately determine the time to percutaneous coronary interventions, approaches to revascularization; the updates touch upon fibrinolytic therapy and new approaches to lipid-lowering therapy too. Recommendations for the management of patients with peripheral artery atherosclerosis propose for the first time a section devoted to the choice of antiplatelet therapy (an antiaggregant and/or an anticoagulant) depending on the clinical situation.
本文概述了2017年更新的欧洲心脏病学会（ESC）指南。今年夏末公布了双抗血小板治疗（DAT）、ST段抬高型心肌梗死（STEMI）患者治疗以及心脏瓣膜病和外周动脉疾病患者管理等领域的修订和修正指南。本文作者对上述领域患者诊断和治疗关键问题的新数据进行了独立分析和讨论。关于DAT的建议特别关注治疗时机及其药物选择。STEMI患者治疗的更新数据准确确定了经皮冠状动脉介入治疗的时间、血运重建方法；更新内容还涉及溶栓治疗和降脂治疗的新方法。外周动脉粥样硬化患者管理的建议首次提出了一个专门根据临床情况选择抗血小板治疗（抗聚集剂和/或抗凝剂）的章节。
