The Appropriateness of Antithrombotic Therapy in Patients With Non-Valvular Atrial Fibrillation in Real Clinical Practice

Abstract

Ключевые слова: фибрилляция предсердий, оральные антикоагулянты, профилактика инсульта. A.Y. RYCHKOV, MD, N.Y. KHORKOVA, PhD in medicine, A.V. MINULINA Branch of Cardiology Research Institute «Tyumen Cardiology Center» THE APPROPRIATENESS OF ANTITHROMBOTIC THERAPY IN PATIENTS WITH NON-VALVULAR ATRIAL FIBRILLATION IN REAL CLINICAL PRACTICEThe article evaluates the risk of thromboembolic complications and appropriateness of oral anticoagulants (OAC) in patients with non-valvular atrial fibrillation (AF) upon admission to inpatient treatment at the Tyumen Cardiology Center in 2014. The majority of patients with non-valvular AF, which is 82% of the total number of patients admitted to the hospital, were referred to the high risk group for thromboembolic events (≥ 2 points according to CHA 2 DS 2 VASc). Before hospitalization, 39.4% of high-risk patients were taking OAC, the majority receiving warfarin. The therapeutic INR range at admission was registered in 30.8% of patients treated with warfarin. 11.1% of high-risk patients received new OAC. Thus, the anticoagulant therapy could be appropriate in 205 patients (19.8% of the high-risk group). There was a relationship between OAC treatment and the risks according to CHADS 2 and HAS-BLED, but not CHA 2 DS 2 VASc. OAC were more frequently administered by patients with persistent AF. The article demonstrates the need for a comprehensive educational and organizational initiative aimed at ensuring antithrombotic therapy which corresponds to the current clinical guidelines for patients with non-valvular AF.

Antithrombotic Therapy in Atrial Fibrillation and Chronic Ischemic Heart Disease

“…По данным регистров, доля больных, получавших комбинацию антитромботических препаратов, у принимавших ПОАК составила в регистре ORBIT-AF 35 % [12], в REACH -37 % [13], в CLARIFY -46 % [2]. Из пациентов, наблюдавшихся в нашей клинике в 2014 г. и принимавших ПОАК, сочетание с антиагрегантами на момент поступления получали 12 % [8].…”