Медицинский совет (Sep 2021)
Safety and efficacy of acetylsalicylic acid in the secondary prevention of cardiovascular diseases in combination with comorbid diseases. COVID-19 treatment options
Abstract
Secondary prevention of cardiovascular disease with aspirin is a very important issue. Аcetylsalicylic acid ensures the prevention of premature death, inhibition of progression and the achievement of partial regression of coronary atherosclerosis, prevention of clinical complications and exacerbations of the disease, reduction of the number of cases and the duration of hospitalization. The most promising direction of modern cardiology is considered to be the prevention of cardiovascular diseases (CVD) and their complications (CVD). This is due to two factors: an increase in the life expectancy of the world’s population as a whole and the persistent leadership of coronary heart disease and brain stroke as the leading causes of death, and disability. The pathogenetic aspects of the administration of acetylsalicylic acid are discussed. The most common dosage form of low-dose (ld) preparations of acetylsalicylic acid (ASA) for preventive use is an intestinal-soluble tablet — 80.6% in the structure of ldASK preparations. Low-dose ASK preparations are mainly presented (84.4%) in the form of monopreparations containing only ASA as the active substance, most often at a dose of 100 mg. However, the side effects of aspirin limit drug intake. This is also due to the high frequency of comorbid diseases such as bronchial asthma and stomach ulcer. The article discusses the issue of prescribing acetylsalicylic acid and the possibility of treating patients with concomitant bronchial asthma, gastric ulcer and obesity. The prevalence of gastroduodenal lesions was significantly lower with intestinal-coated ASA than with buffered acetylsalicylic acid. It was demonstrated that endoscopic lesions of the gastroduodenal mucosa were significantly less likely when using intestinal-coated ASA (100 mg / day) than when using conventional аcetylsalicylic acid, and the assessment of the lesion when using intestinalcoated ASA was similar to the assessment of placebo without аcetylsalicylic acid. In addition, the issue of the possibility of including аcetylsalicylic acid in the treatment regimen for COVID 19 is being discussed.
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