Anticoagulant Therapy for Atrial Fibrillation in Real Practice: Problems and Prospects

Abstract

In the review of the current literature urgent issues of treatment of patients with atrial fibrillation are analyzed, namely prevention of thrombosis and the use of anticoagulants therapy. The article describes the current possibilities of prevention thromboembolic complications in patients with atrial fibrillation at high risk. The fact of insufficient use of preventive antithrombotic therapy in patients with atrial fibrillation with high thrombotic risk is demonstrated, which is associated both with incomplete adherence of doctors to the implementation of clinical recommendations, and with low adherence of patients to receiving prescribed anticoagulants. The review of the literature discusses the difficulties of the use of oral anticoagulants, in particular direct action and their high financial burden, and anticoagulants indirect action and instability of their pharmacological effect. The article demonstrates the difficulties of warfarin therapy, such as insufficient adherence to treatment, genetic characteristics of the patient, alimentary and drug interactions. When discussing the issue of insufficient adherence, it is shown that the data on adherence to drug therapy are not homogeneous and do not fully take into account the influence of patient-dependent characteristics. The prospects of developing an individualized algorithm for choosing an anticoagulant for long-term administration for patients with atrial fibrillation from the position of a patient-oriented approach are separately discussed.

Role of Folic Acid Drugs in the Treatment with Antithrombotic and Anticoagulant Drugs for Patients with Cardiovascular Diseases Based on the Analysis of Virtual Reality Medical Data

“…Realizing the monitoring of user's physiological information anytime and anywhere is an important part of modern medical treatment. Therefore, the proposal of smart medical treatment is also proposed by using the technological development of modern wireless communication and portable equipment [ 20 , 21 ].…”

“…erefore, the proposal of smart medical treatment is also proposed by using the technological development of modern wireless communication and portable equipment [20,21].…”

Gene polymorphism as a cause of hemorrhagic complications in patients with non-valvular atrial fibrillation treated with oral vitamin K-independent anticoagulants

“…Atrial fibrillation (AF), a type of arrhythmia, accounts for 40% of all cardiac arrhythmias and is associated with an increased risk of thromboembolic events, including stroke, resulting in morbidity and mortality. 1 The prevalence of AF is steadily increasing. According to the population-based Framingham study published in 2015, the incidence of AF increased by 4.7 times in men and 3.6 times in women over a 50-year follow-up period.…”

“… 7 , 9 , 10 DOACs share common characteristics: they have a shorter half-life (lasting between 5 and 17 h) compared to warfarin, pose a reduced risk of drug interactions, do not require laboratory monitoring, offer fixed dosages, and have a broad ‘therapeutic window’. 1 , 7 , 11 When the efficacy of DOACs was compared with that of another representative of long-acting vitamin K antagonists, phenprocoumon, the risks of thromboembolic complications were significantly higher; however, the risk of bleeding was lower than that of phenprocoumon. 12 , 13 DOACs have a wide therapeutic index, fast onset and cessation of action, and relatively low potential for interactions with other drugs and food.…”