clinmedКлиническая медицинаClinical Medicine (Russian Journal)0023-21492412-1339ООО «Медицинское информационное агентство»10.30629/0023-2149-2020-98-4-245-250clinmed-40Research ArticleОБЗОРЫ И ЛЕКЦИИREVIEWS AND LECTURESОстрый коронарный синдром и транзиторные ишемические атаки: клинические и терапевтические параллелиAcute coronary syndrome and transient ischemic attacks: clinical and therapeutic parallelsСимоненкоВ. Б.SimonenkoV. B.

107392, Москва.

107392, Moscow.

ШироковЕ. А.ShirokovE. A.

Широков Евгений Алексеевич — доктор медицинских наук, профессор.

107392, Москва.

Evgenii A. Shirokov — MD, PhD, DSc, prof.

107392, Moscow.

evg-747747@yandex.ruОвчинниковЮ. В.OvchinnikovYu. V.

107392, Москва.

107392, Moscow.

Военно-медицинская академия им. С.М. Кирова (филиал)РоссияS.M. Kirov, Military Medical Academy (Branch)Russian Federation202016092020984245250Copyright © Симоненко В.Б., Широков Е.А., Овчинников Ю.В., 20202020Симоненко В.Б., Широков Е.А., Овчинников Ю.В.Simonenko V.B., Shirokov E.A., Ovchinnikov Y.V.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/40

Транзиторная ишемическая атака является клиническим вариантом острого нарушения мозгового кровообращения без признаков повреждения тканей мозга. Транзиторная ишемическая атака увеличивает вероятность инсульта, инфаркта миокарда и других сосудистых событий. Существует очевидное сходство между транзиторной ишемической атакой и острым коронарным синдромом без подъема ST. Авторы статьи обсуждают возможности агрессивной терапевтической тактики ведения больных с транзиторными ишемическими атаками, основываясь на результатах высокой эффективности такого лечения при остром коронарном синдроме.

Transient ischemic attack is a clinical variant of acute cerebral circulatory disorders without signs of damage to brain tissue. A transient ischemic attack increases the likelihood of stroke, myocardial infarction, and other vascular events. There is an obvious similarity between transient ischemic attack and acute coronary syndrome without St elevation. The authors discuss the possibilities of aggressive therapeutic tactics for managing patients with transient ischemic attacks based on the results of high effi ciency of such treatment in acute coronary syndrome.

транзиторная ишемическая атакадвойная антитромбоцитарная терапияагрессивная терапиявнутричерепные кровоизлиянияострый коронарный синдромtransient ischemic attackdouble antiplatelet therapyaggressive therapyintracranial hemorrhagesacute coronary syndromeReferencesAmarenco P., Lavallee C., Monteiro Tavares L. Five-year risk of stroke after TIA or minor ischemic stroke. New Eng. J. Med. 2018. DOI: 10.1056/NEJMoa1802712.Amarenco P., Lavallce C., Monteiro Tavares L. Five-year risk of stroke after TIA or minor ischemic stroke. New Eng. J. Med. 2018. org. DOI: 10.1056/NEJMoa1802712Giles M.F., Albers G.W., Amarenco P. et al. Early stroke risk and ABCD2 score performance in tissue — vs time defined TIA. Neurology. 2011;77:1222-28.Giles M.F., Albers G.W., Amarenco P. et al. Early stroke risk and ABCD2 score performance in tissue — vs time defined TIA. Neurology. 2011;77:1222-28.Uchiyama S., Amarenco P., Minematsu K. et al. TIA as Acute Cerebrovascular Syndrome. Front Neurol Neurosci. Basel, Karger. 2014;33:135-46. DOI: 10.1159/000351914Uchiyama S., Amarenco P., Minematsu K. et al. TIA as Acute Cerebrovascular Syndrome. Front. Neurol. Neurosci. Basel, Karger. 2014;33:135-46. DOI: 10.1159/000351914Симоненко В.Б., Широков Е.А., Фролов В.М. Клиническая кризология в кардионеврологии. — М.: КВОРУМ, 2013.Simonenko V.B., Shirokov E.A., Frolov V.M. Clinical cryology in cardioneurology. M.: KVORUM, 2013. (in Russian)Kernan W.N., Ovbiagele B., Black H.R. et al. Guidelines for the primary prevention of stroke: a statement for healthcare professionals from the American Heart Association. American Stroke Association. Stroke. 2014;45:2160-236.Kernan W.N., Ovbiagele B., Black H.R. et al. Guidelines for the Primary Prevention of Stroke: A Statement for Healthcare Professionals from the American Heart Association. American Stroke Association. Stroke. 2014;45:2160-236.Парфенов В.А., Хасанова Д.Р. Ишемический инсульт. — М.: Медицинское информационное агентство, 2012.Parphenov V.A., Chasanova D.R. Ischemic stroke. M.: Medicinskoe informazionnoe agentstvo, 2012. (in Russian)Bae H.J., Yoon B.W., Kang D.W., Koo J.S., Lee S.H., Kim K.B. et al. Correlation of coronary and cerebral atherosclerosis: difference between extracranial and intracranial arteries. Cerebrovasc. Dis. 2006;21:112-9.Bae H.J., Yoon B.W., Kang D.W., Koo J.S., Lee S.H., Kim K.B. et al. Correlation of coronary and cerebral atherosclerosis: difference between extracranial and intracranial arteries. Cerebrovasc. Dis. 2006;21:112-9.Agusti A., Bel E., Thomas M. et al. Treatable traits: toward precision medicine of chronic airway diseases. Eur. Respir. J. 2016;47:410-9. DOI: 10.1183/13993003.01359-2015Agusti A., Bel E., Thomas M. et al. Treatable traits: toward precision medicine of chronic airway diseases. Eur. Respir. J. 2016;47:410-419. DOI: 10.1183/13993003.01359-2015Jameson J.L., Longo D.L. Precision medicine — personalized, problematic, and promising. N. Engl. J. Med. 2015;372:2229-34.Jameson J.L., Longo D.L. Precision medicine — personalized, problematic, and promising. N. Engl. J. Med. 2015;372:2229-34.Mozaffarian D., Benjamin E., Go A. et al. Heart Disease and Stroke Statistics-2016 Update. Circulation. 2016;133(4): e38-e360.Mozaffarian D., Benjamin E., Go A. et al. Heart Disease and Stroke Statistics-2016 Update. Circulation. 2016;133(4):e38-e360.Roffi M., Patrono C., Collet J.P., Mueller C. et al. 2015 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation: task force for the management of acute coronary syndromes in patients presenting without persistent st-segment elevation of the European Society of Cardiology (ESC). Eur. Heart. J. 2016;37(3):267-315.Roffi M., Patrono C., Collet J.P., Mueller C. et al. 2015 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation: task force for the management of acute coronary syndromes in patients presenting without persistent st-segment elevation of the European Society of Cardiology (ESC). Eur. Heart. J. 2016;37(3):267-315.Widimsky P., Coram R., Abou-Cheb A. Reperfusion therapy of acute ischaemic stroke and acute myocardial infarction: similarities and differences. Eur. Heart J. 2014;35:147-55.Widimsky P., Coram R., Abou-Cheb A. Reperfusion therapy of acute ischaemic stroke and acute myocardial infarction: similarities and differences. Eur. Heart J. 2014;35:147-55.Mok V., Kim J. Prevention and Management of Cerebral Small Vessel Disease. J. Stroke. 2015;17(2):111-22.Mok V., Kim J. Prevention and management of cerebral small vessel disease. J. Stroke. 2015;17(2):111-22.Dolmans L.S., Hoes A., Bartelink E. et al. Patient delay in TIA: a systematic review. J. Neurol. 2018. DOI:10.1007/s00415-018-8977-6.Dolmans L.S., Hoes A., Bartelink E. et al. Patient delay in TIA: a systematic review. J. Neurology. 2018. DOI:10.1007/s00415-018-8977-6Lavallee P., Amarenco P. Stroke subtypes and interventional studies for transient ischemic attack. tia as acute cerebrovascular syndrome. front. Neurol. Neurosci. Basel, Karger, 2014;33:135-46. DOI: 10.1159/000351914Lavallce P., Amarenco P. Stroke Subtypes and Interventional Studies for Transient Ischemic Attack. TIA as Acute Cerebrovascular Syndrome. Front. Neurol. Neurosci. Basel, Karger, 2014;33:135-46. DOI: 10.1159/000351914Chen Z.M., Sandercoch P., Pan H.C. et al. Indication for early aspirin use in acute ischemic stroke. A combined analysis of 40 000 randomized patients from the Chines Acute Stroke Trial and the International Stroke Trial. Stroke. 2000; 31: 1240-1249.Chen Z.M., Sandercoch P., Pan H.C. et al. Indication for early aspirin use in acute ischemic stroke. A combined analysis of 40 000 randomized patients from the Chines Acute Stroke Trial and the International Stroke Trial. Stroke. 2000;31:1240-9.Kennedy J., Ryckborst K. et al. For the FASTER investigators: Fast Assessment of Stroke and Transient Ischemic Attack to prevent Early Recurrence (FASTER): a randomized controlled pilot trial. Lancet Neurol. 2007;6:961-9.Kennedy J., Ryckborst K. et al. For the FASTER investigators: Fast Assessment of Stroke and Transient Ischemic Attack to prevent Early Recurrence (FASTER): a randomized controlled pilot trial. Lancet Neurol. 2007; 6: 961-9.Powers W., Rabinstein A., Ackerson T. et al. 2018 Guidelines for the Early Management of Patients With Acute Ischemic Stroke. A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association. Stroke. 2018;49:eXXX-eXXX. DOI: 10.1161/STR.0000000000000158Powers W., Rabinstein A., Ackerson T. et al. 2018 Guidelines for the Early Management of Patients With Acute Ischemic Stroke. A Guideline for Healthcare Professionals From the American Heart Association. American Stroke Association. Stroke. 2018;49:eXXX-eXXX. DOI: 10.1161/STR.0000000000000158Prasad K., Siemieniuk R., Hao Q. Dual antiplatelet therapy with aspirin and clopidogrel for acute high risk transient ischaemic attack and minor ischaemic stroke: a clinical practice guideline. BMJ. 2018;363:k5130. DOI: 10.1136/bmj.k5130Prasad K., Siemieniuk R., Hao Q. Dual antiplatelet therapy with aspirin and clopidogrel for acute high risk transient ischaemic attack and minor ischaemic stroke: a clinical practice guideline. BMJ. 2018;363:k5130. DOI: 10.1136/bmj.k5130 (Published 18 December 2018).Sandercock P., Counsell C., Tseng M.C., Cecconi E. Oral antiplatelet therapy for acute ischemic stroke. Cochrane Database System. Rev. 2014;3:CD000029. DOI: 10.1002/14651858.CD000029.pub3Sandercock P., Counsell C., Tseng M.C., Cecconi E. Oral antiplatelet therapy for acute ischemic stroke. Cochrane Database System. Rev. 2014;3:CD000029. DOI: 10.1002/14651858.CD000029.pub3Li Z., Wang Y., Zhao X. et al. Treatment effect of clopidogrel plus aspirin within 12 hours of acute minor stroke or transient ischemic attack. J. Am. Heart. Assoc. 2016;5:e003038. DOI:10/1161/JAHA.115.003038Li Z., Wang Y., Zhao X. et al. Treatment effect of clopidogrel plus aspirin within 12 hours of acute minor stroke or transient ischemic attack. J. Am. Heart. Assoc. 2016;5:e003038. DOI:10/1161/JAHA.115.003038Sharma V.K., Tan B.Y., Ying Sim M.Y. Rationale and design of a randomized trial of early intensive blood pressure lowering on cerebral perfusion parameters in thrombolysed acute ischemic stroke patients. Medicine. 2018;97:40 (e12721). DOI.org/10.1097/MD.0000000000012721Sharma V.K., Tan B.Y., Ying Sim M.Y. Rationale and design of a randomized trial of early intensive blood pressure lowering on cerebral perfusion parameters in thrombolysed acute ischemic stroke patients. Medicine. 2018;97:40(e12721). DOI.org/10.1097/MD.0000000000012721Симоненко В.Б., Широков Е.А., Овчинников Ю.В. Клинические особенности течения артериальной гипертонии, осложненной перенесенным ишемическим инсультом. Клиническая медицина. 2007;85(9):45-9.Simonenko V.B., Shirokov E.A., Ovchinnikov J.V. Clinical features of arterial hypertension complicated by ischemic stroke Klinicheskaya meditsina. 2007;85(9):45-9. (in Russian)Powers W.J. Acute hypertension after acute stroke: the scientific basis for treatment decisions. Neurology. 1993;43:461-7.Powers W.J. Acute hypertension after acute stroke: the scientific basis for treatment decisions. Neurology. 1993;43:461-7.Fischberg G.M., Lozano E., Rajamani K. et al. Stroke precipitated by moderate blood pressure reduction. J. Emerg. Med. 2000;19: 339-46.Fischberg G.M., Lozano E., Rajamani K. et al. Stroke precipitated by moderate blood pressure reduction. J. Emerg. Med. 2000;19:339-46.Anderson C.S., Huang Y., Lindley R.I. et al. Intensive blood pressure reduction with intravenous thrombolysis therapy for acute ischaemic stroke (ENCHANTED): an international, randomised, open-label, blinded-endpoint, phase 3 trial. Published Online February 7, 2019. http://dx.doi.org/10.1016/S0140-6736(19)30038-8.Anderson C.S., Huang Y., Lindley R.I. et al. Intensive blood pressure reduction with intravenous thrombolysis therapy for acute ischaemic stroke (ENCHANTED): an international, randomised, open-label, blinded-endpoint, phase 3 trial. 2019. http://dx.doi.org/10.1016/S0140-6736(19)30038-8Skalidi S.J., Manios E.D., Stamatelopoulos K.S. et al. Brain edema formation is associated with the time rate of blood pressure variation in acute stroke patients. Blood Press Monit. 2013;18(4):203-7.Skalidi S.J., Manios E.D., Stamatelopoulos K.S. et al. Brain edema formation is associated with the time rate of blood pressure variation in acute stroke patients. Blood Press Monit. 2013; 18 (4): 203-207.Фонякин А.В., Гераскина Л.А. Профилактика ишемического инсульта. Рекомендации по гиполипидемической терапии. М. : ИМАПРЕСС, 2015.Fonyakin A.V., Geraskina L.A. Prevention of ischemic stroke. Recommendations for hypolipidemic therapy. Moscow: IMAPRESS, 2015.Pan Y. Outcomes Associated With Clopidogrel-Aspirin Use in Minor Stroke or Transient Ischemic Attack. 2019. DOI:10.1001/jamaneurol.2019.2531Pan Y. Outcomes Associated With Clopidogrel-Aspirin Use in Minor Stroke or Transient Ischemic Attack/Published online August 19,2019 doi:10.1001/jamaneurol.2019.2531

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