Журнал "Атеротромбоз" №1, 2019

DOI: https://doi.org/10.21518/2307-1109-2019-1-44-52
Л. И. Кудрявцева, ассистент кафедры, Е. В. Филиппов, д.м.н., зав. кафедрой, Федеральное государственное бюджетное образовательное учреждение высшего образования «Рязанский государственный медицинский университет имени академика И. П. Павлова» Министерства здравоохранения Российской Федерации
За последние 20 лет бремя фибрилляции предсердий (ФП) увеличилось. ФП ассоциируется с повышением риска смерти, ишемического инсульта и инвалидности, частоты госпитализации и снижением качества жизни больных. В основе терапии данной патологии лежит коррекция факторов риска основного заболевания и антикоагулянтная терапия. В обзоре рассмотрены стратегии минимизации риска осложнений на фоне терапии оральными антикоагулянтами.

A strategy for managing a patient with atrial fibrillation to reduce the risk of thromboembolic complications

Larisa I. Kudryavtseva, Assistant of the Department of Polyclinic Therapy, Evgeny V. Filippov, Dr. of Sci. (Med), Head of the Department, Federal State Budgetary Educational Institution of Higher Education «Ryazan State Medical University named after Academician I. P. Pavlov» 
Over the past 20 years, the burden of atrial fibrillation (AF) has increased. AF is associated with increased risk of death, ischemic stroke and disability, hospitalization rates, and reduced quality of life. Treatment for this pathology is based on the correction of risk factors, underlying disease and anticoagulant therapy. The review considers strategies to minimize the risk of complications during oral anticoagulant therapy.

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Литература / References

1. 
   
2. Сафарова Г. Л. Россия в стареющем мире. Материалы Междунар. науч. конгр. «Глобалистика-2009: пути выхода из глобального кризиса и модели нового мироустройства». Под общ. ред. И. И. Абылгазиева, И. В. Ильина. М.: МАКС Пресс, 2009;2:198-201.
   
   
3. Sаntos-Lozаno А., Sаnchis-Gomаr F., Pаrejа-Gаleаno H. et аl. Where аre supercentenаriаns locаted? А worldwide demogrаphic study. Rejuvenаtion Res. 2015;18:14-19.
   
   
4. Global status report on non communicable diseases 2014. WHO. Geneva, 2015. 282 p. ISBN 978-92-4-156485-4.
   
   
5. Kаnnel W. B., Benjаmin E. J. Stаtus of the epidemiology of аtriаl fibrillаtion. Med. Clin. North Аm. 2008;92 (1):17-40.
   
   
6. Оганов Р. Г., Шальнова С. А., Калинина А. М. Профилактика сердечно-сосудистых заболеваний: руководство. М.: ГЭОТАР-Медиа, 2009. 216 с. ISBN 978-5-9704-1110-0.
   
   
7. Kirchhof P., Benussi S., Kotecha D., Ahlsson A., Atar D., Casadei B., Castella M., Diener H.-Ch., Heidbuchel H., Hendriks J., Hindricks G., Manolis A. S., Oldgren J., Popescu B. A., Schotten U., Van Putte B., Vardas P., ESC Scientific Document Group, 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS. European Heart Journal. 2016 October 7;37 (38):2893-2962. https://doi.org 10.1093 / eurheartj/ ehw210.
   
8. Schnаbel R. B. et аl. 50 yeаr trends in аtriаl fibrillаtion prevаlence, incidence, risk fаctors, аnd mortаlity in the Frаminghаm Heаrt Study: а cohort study. Lаncet. 2015 Jul;386 (9989):154-162.
   
   
9. Griffiths H. R., Lip G. Y. Biomаrkers аnd Risk Strаtificаtion in Аtriаl Fibrillаtion. Circulаtion. 2014 Oct 7:1837-1839.
   
   
10. Saver J. L. Cryptogenic stroke. N Engl J Med. 2016;374:2065-2074.
    
    
11. Grau A. J., Weimar C., Buggle F. et al. Risk factors, outcome and treatment in subtypes of ischemic stroke. The German stroke data bank. Stroke. 2001;32:2559-2566.
    
    
12. Dalen J. E. Prevention of embolic strokes. The role of the American College of Chest Physicians. Chest. 2012;141:294-299.
    
    
13. Tsang T. S., Petty G. W., Barnes M. E. et al. The prevalence of atrial fibrillation in incident stroke cases and matched population controls in Rochester, Minnesota. J Am Coll Cardiol. 2003;42:93-100.
    
    
14. Hohnloser S. H., Pajitnev D., Pogue J. et al. Incidence of stroke in paroxysmal versus sustained atrial fibrillation in patients taking oral anticoagulation or combined antiplatelet therapy. J Am Coll Cardiol. 2007;50:2156-2161.
    
    
15. Hart R. G., Pearce L. A., Rothbart R. M. et al. Stroke with intermittent atrial fibrillation: incidence and predictors during aspirin therapy. J Am Coll Cardiol. 2000;35:183-187.
    
    
16. Sposato L. A., Cipriano L. E., Saposnik G. et al. Diagnosis of atrial fibrillation after stroke and transient ischaemic attack: a systematic review and metaanalysis. Lancet Neurol. 2015;14:377-387.
    
    
17. Seet R. C. S., Friedman P. A., Rabinstein A. A. Prolonged rhythm monitoring for the detection of occult paroxysmal atrial fibrillation in ischemic stroke of unknown cause. Circulation. 2011;124:477-486.
    
    
18. Healey J. S., Connolly S. J., Gold M. R. et al. Subclinical atrial fibrillation and the risk of stroke. N Engl J Med. 2012;366:120-129.
    
    
19. Boriani G., Glotzer T. V., Santini M. et al. Devicedetected atrial fibrillation and risk for stroke: an analysis of >10,000 patients from the SOS AF project (stroke prevention on strategies based on atrial fibrillation information from implanted devices). Eur Heart J. 2014;35:508-516.
    
    
20. Airaksinen K. E. J., Gronberg T., Nuotio L. et al. Thromboembolic complications after cardioversion of acute atrial fibrillation: the FinCV (Finnish Cardioversion) Study. J Am Coll Cardiol. 2013;62:1187-1192.
    
    
21. Hansen M. L., Jepsen R. M. H. G., Olesen J. B. et al. Thromboembolic risk in 16,274 atrial fibrillation patients undergoing direct current cardioversion with and without oral anticoagulant therapy. Europace. 2015;17:18-23.
    
22. Connolly S. J., Ezekowitz M. D., Yusuf S. et al. Dabigatran versus warfarin in patients with atrial fibrillation. N Engl J Med. 2009;361:1139.
    
    
23. Guillaume Turc G., Calvet D., Guerin P. et al. Closure, Anticoagulation, or Antiplatelet Therapy for Cryptogenic Stroke With Patent Foramen Ovale: Systematic Review of Randomized Trials, Sequential Meta-Analysis, and New Insights From the CLOSE Study. J Am Heart Assoc. 2018;7: e008356. https://doi.org/10.1161/JAHA.117.008356.
    
    
24. Brandes A., Smit M. D., Nguyen B. O. et al. Risk Factor Management in Atrial Fibrillation. Arrhythmia & Electrophysiology Review. 2018;7 (2):118-27. https:// http://doi.org 10.15420 / aer.2018.18.2.
    
    
25. Granger C. B., Alexander J. H., McMurray J. J., Lopes R. D., Hylek E. M., Hanna M., Al-Khalidi H. R., Ansell J., Atar D., Avezum A., Bahit M. C., Diaz R., Easton J. D., Ezekowitz J. A., Flaker G., Garcia D., Geraldes M., Gersh B. J., Golitsyn S., Goto S., Hermosillo A. G., Hohnloser S. H., Horowitz J., Mohan P., Jansky P., Lewis B. S., Lopez-Sendon J. L., Pais P., Parkhomenko A., Verheugt F. W., Zhu J., Wallentin L., ARISTOTLE Committees and Investigators. Apixaban versus warfarin in patients with atrial fibrillation. N Engl J Med. 2011;365:981-992.
    
    
26. Connolly S. J., Eikelboom J., Joyner C., Diener H. C., Hart R., Golitsyn S., Flaker G., Avezum A., Hohnloser S. H., Diaz R., Talajic M., Zhu J., Pais P., Budaj A., Parkhomenko A., Jansky P., Commerford P., Tan R. S., Sim K. H., Lewis B. S., Van Mieghem W., Lip G. Y., Kim J. H., Lanas-Zanetti F., Gonzalez-Hermosillo A., Dans A. L., Munawar M., O’Donnell M., Lawrence J., Lewis G., Afzal R., Yusuf S., AVERROES Steering Committee Investigators. Apixaban in patients with atrial fibrillation. N Engl J Med. 2011;364:806-817.
    
    
27. Hylek E. M., Held C., Alexander J. H., Lopes R. D., De Caterina R., Wojdyla D. M., Huber K., Jansky P., Steg P. G., Hanna M., Thomas L., Wallentin L., Granger C. B. Major bleeding in patients with atrial fibrillation receiving apixaban or warfarin: The ARISTOTLE Trial (Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation): Predictors, Characteristics, and Clinical Outcomes. J Am Coll Cardiol. 2014;63:2141-2147.
    
    
28. Flaker G. C., Eikelboom J. W., Shestakovska O., Connolly S. J., Kaatz S., Budaj A., Husted S., Yusuf S., Lip G. Y., Hart R. G. Bleeding during treatment with aspirin versus apixaban in patients with atrial fibrillation unsuitable for warfarin: the apixaban versus acetylsalicylic acid to prevent stroke in atrial fibrillation patients who have failed or are unsuitable for vitamin K antagonist treatment (AVERROES) trial. Stroke. 2012;43:3291-3297.
    
    
29. Badi M. K., Vilanilam G. K., Gupta V. Pharmacotherapy for Patients With Atrial Fibrillation and Cerebral Microbleeds. J Stroke Cerebrovasc Dis. 2019 May 15. pii: S1052-3057 (19) 30196-X. https://doi.org/10.1016 / j.jstrokecerebrovasdis.2019.04.027.