Acetylsalicylic acid retains its position in secondary prevention of CVD
Karpov Yu.A.

National Medical Research Center of Cardiology, Moscow

The article is devoted to the possibilities of using acetylsalicylic acid (ASA) in the pharmacotherapy of cardiovascular diseases (CVD) for primary prevention of cardiovascular complications (CVC). The history of ASA creation and introduction into clinical practice is covered. The mechanism of ASA action depending on the dose of the drug is considered in detail. New data on the effectiveness of ASA, based on the results of two recently completed large studies, are presented. It is shown that according to the results of the analysis of the large Swedish registry, which included patients taking ASA in low cardioprotective doses for primary and secondary CVD prevention, patients who stopped ASA treatment had a significantly higher cardiovascular risk. Among patients who received ASA for secondary prevention of CVD, discontinuation of the use of the drug was associated with an increase in the incidence of cardiovascular events by 46%. The results of another new study, COMPASS, comparing the efficacy of oral anticoagulant rivaroxaban and ASA in patients with stable course of coronary heart disease and / or atherosclerosis of peripheral arteries, demonstrated that the use of a combination of rivaroxaban and ASA reduced the risk of cardiovascular events by 24%, and the number of large bleedings increased by 70%. In patients taking only rivaroxaban, in comparison with ASA alone, there were no significant differences in the incidence of CVC, but the number of bleedings significantly increased. The data indicate that ASA therapy continues to be effective in reducing the risk of CVCs and remains safe.

Key words: cardiovascular diseases, acetylsalicylic acid, cardiovascular complications, secondary prevention.
For citation: Karpov Yu.A. Acetylsalicylic acid retains its position in secondary prevention of CVD // RMJ. 2017. № 20. P. 1457–1462.