clinmedКлиническая медицинаClinical Medicine (Russian Journal)0023-21492412-1339ООО «Медицинское информационное агентство»10.30629/0023-2149-2025-103-7-499-505clinmed-1201Research ArticleОБЗОРЫ И ЛЕКЦИИREVIEWS AND LECTURESСовременные тромболитические препараты в лечении инфаркта миокардаModern thrombolytic drugs in the treatment of myocardial infarction, pharmacoinvasive approachhttps://orcid.org/0009-0008-6043-2469ВязоваН. Л.VyazovaN. L.

Вязова Наталья Львовна — врач-кардиолог, ассистент кафедры кардиологии, рентгенэндоваскулярных и гибридных методов диагностики и лечения факультета дополнительного профессионального образования

Москва

Natalya L. Vyazova — cardiologist, assistant at the Department of Cardiology, X-ray endovascular and hybrid methods of diagnosis and treatment, Faculty of Additional Professional Education

Moscow 

https://orcid.org/0009-0007-5497-9313ЛахмайК. С.LakhmaiK. S.

Лахмай Кирилл Сергеевич — врач рентгенэндоваскулярный хирург 

Москва

Kirill S. Lakhmai — X-ray endovascular surgeon 

Moscow 

https://orcid.org/0009-0000-3891-1983ПростатовМ. Н.ProstatovM. N.

Простатов Максим Николаевич — врач сердечно-сосудистый хирург 

Москва

Maxim N. Prostatov — cardiovascular surgeon 

Moscow 

https://orcid.org/0000-0001-5112-3068КолединскийА. Г.KoledinskyA. G.

Колединский Антон Геннадьевич — д-р мед. наук, заведующий кафедрой кардиологии, рентгенэндоваскулярных и гибридных методов диагностики и лечения факультета дополнительного профессионального образования

Москва

Anton G. Koledinsky — Doctor of Medical Sciences, Head of the Department of Cardiology, X-ray Endovascular and Hybrid Methods of Diagnostics and Treatment, Faculty of Additional Professional Education

Moscow 

koledant@mail.ruФГАОУ ВО «Российский университет дружбы народов им. Патриса Лумумбы» Минобрнауки России (РУДН) ; ООО «СМ-Клиника»РоссияPeoples’ Friendship University of Russia named after Patrice Lumumba (RUDN University) ; SM-Clinic LLCRussian FederationООО «СМ-Клиника»РоссияSM-Clinic LLCRussian Federation2025261120251037499505Copyright © Вязова Н.Л., Лахмай К.С., Простатов М.Н., Колединский А.Г., 20252025Вязова Н.Л., Лахмай К.С., Простатов М.Н., Колединский А.Г.Vyazova N.L., Lakhmai K.S., Prostatov M.N., Koledinsky A.G.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.clinmedjournal.com/jour/article/view/1201

Острый инфаркт миокарда, несмотря на успехи современной медицины, сохраняет одну из лидирующих позиций в причинах инвалидизации и смертности. С целью улучшения прогноза у больных с острым инфарктом миокарда, уменьшения очага некроза, снижения летальности разработана современная реперфузионная терапия. В данном обзоре рассмотрены возможные сроки проведения тромболизиса, оценка актуальности и особенности фармакоинвазивного подхода в лечении острого инфаркта миокарда. Проанализированы крупные рандомизированные клинические исследования, направленные на изучение эффективности и безопасности проведения тромболитической терапии. Приведены механизмы действия тромболитических препаратов, их сравнительная характеристика. Оценивались свойства «идеального» тромболитика. Показаны преимущества препарата неиммуногенной стафилокиназы — фортеплазе — для использования как на догоспитальном этапе, так и в условиях стационара.

Despite the successes of modern medicine, retains one of the leading positions in the causes of disability and mortality. In order to improve the prognosis of patients with acute myocardial infarction, reduce the focus of necrosis, and reduce mortality, modern reperfusion therapy has been developed. This review examines the possible timing of thrombolysis, assessment of the relevance and features of the pharmacoinvasive approach in the treatment of acute myocardial infarction. Large randomized medical trials aimed at studying the effectiveness and safety of thrombolytic therapy were analyzed. We compared properties of thrombolytic drugs, their mechanism of action. The properties of an “ideal” thrombolytic were assessed. The advantages of the non-immunogenic staphylokinase drug- forteplase, are shown for use both stages — prehospital stage and in-hospital.

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The authors declare that there are no conflicts of interest present.