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ВЫБОР ПРЯМЫХ ОРАЛЬНЫХ АНТИКОАГУЛЯНТОВ С УЧЕТОМ ИНДИВИДУАЛЬНЫХ ОСОБЕННОСТЕЙ ПАЦИЕНТА

https://doi.org/10.18705/2311-4495-2018-5-6-10-22

Аннотация

Данная обзорная статья посвящена сравнению различных режимов антикоагулянтной терапии с учетом профиля риска и индивидуальных особенностей пациентов с фибрилляцией предсердий. В работе анализируется эффективность и безопасность прямых оральных антикоагулянтов в разных клинических ситуациях. Оцениваются модифицируемые и немодифицируемые факторы риска кровотечения, основанные на шкалах оценки риска геморрагических осложнений у пациентов, принимающих антикоагулянты. Приводится доказательная база по назначению антикоагулянтной терапии при наличии единственного эпизода фибрилляции предсердий. Рассматриваются режимы и сроки инициации антикоагулянтной терапии после кардиоэмболического инсульта или транзиторной ишемической атаки. Кроме того, уделяется большое внимание проблеме раннего назначения антикоагулянтов после перенесенного внутричерепного кровоизлияния. Для пациентов с высоким риском желудочно-кишечного кровотечения или нарушением функции почек проводится оценка оптимальной стратегии снижения тромбоэмболических осложнений. Отдельно рассматриваются подходы к назначению антикоагулянтной терапии у пациентов со стабильной ишемической болезнью сердца, в том числе после проведения коронарного стентирования.

Об авторах

О. И. Ефимова
ФГБОУ ВО «Самарский Государственный Медицинский Университет» ГБУЗ «Самарская областная клиническая больница имени В.Д. Середавина»,
Россия

соискатель кафедры кардиологии и сердечно-сосудистой хирургии ИПО СамГМУ,

врач терапевт-кардиолог неврологического отделения для больных с острыми нарушениями мозгового кровообращения



Т. В. Павлова
ФГБОУ ВО «Самарский Государственный Медицинский Университет»
Россия
профессор, доктор медицинских наук, профессор кафедры кардиологии и сердечно-сосудистой хирургии ИПО СамГМУ


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Рецензия

Для цитирования:


Ефимова О.И., Павлова Т.В. ВЫБОР ПРЯМЫХ ОРАЛЬНЫХ АНТИКОАГУЛЯНТОВ С УЧЕТОМ ИНДИВИДУАЛЬНЫХ ОСОБЕННОСТЕЙ ПАЦИЕНТА. Трансляционная медицина. 2018;5(6):10-22. https://doi.org/10.18705/2311-4495-2018-5-6-10-22

For citation:


Efimova O.I., Pavlova T.V. CHOICE OF DIRECT ORAL ANTICOAGULANTS BASED ON THE INDIVIDUAL APPROACH. Translational Medicine. 2018;5(6):10-22. (In Russ.) https://doi.org/10.18705/2311-4495-2018-5-6-10-22

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