FIELD: medicine.
SUBSTANCE: invention relates to medicine, namely to cardio-vascular surgery. In order to select anti-platelet therapy in carrying out coronary angioplasty in patients with acute myocardial infarction clinical-instrumental and angiographic predictors are determined; their estimation by scale of risk of cardial complications is carried out and therapy volume is determined. In group of clinical-instrumental predictors are included: age, old myocardial infarction, acute impaired cardial function by Killip, diabetes mellitus, revasculisation of myocardium in past, fraction of left ventricle output. In group of angiographic predictors are included: hemodynamically essential lesions of coronary arteries, blood supply type. Point of determined predictors are summed up, risk of cardiac complications are divided into degrees. For risk of first degree, with the sum of points 1-5, coronary angioplasty is carried out at the background of two-component additional anti-platelet therapy, which includes 500 mg of aspirin and 600 mg of clopidogrel. For risk of the second degree, with the sum 6 and more points, coronary angioplasty is carried out at the background of three-component additional anti-platelet therapy, which includes 500 mg of aspirin, 600 mg of clopidogrel and blocker of glycoprotein IIa/IIIa platelet receptors.
EFFECT: method makes it possible to reduce risk of development of hemorrhagic complications by stratification of patients into groups of risk in carrying out coronary angioplasty with stenting.
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Authors
Dates
2011-05-27—Published
2009-12-03—Filed