2018

150 руб.

Антикоагулянтная терапия у больных с фибрилляцией предсердий в особых ситуациях: сахарный диабет, хроническая болезнь почек

Канорский С. Г.
ФГБОУ ВО «КубГМУ» МЗ РФ, 350063, Краснодар, ул. Седина, д. 4

Ключевые слова: фибрилляция предсердий, антитромботическая терапия, сахарный диабет, хроническая болезнь почек

DOI: 10.18087/cardio.2469

Проведение антикоагулянтной терапии при фибрилляции предсердий (ФП), сочетающейся с СД и/или хронической болезнью почек, является непростой задачей для практикующих врачей из‑за одновременного увеличения риска тромбоэмболических и геморрагических осложнений. Наличие СД и нарушения функции почек способно влиять на результаты антитромботической терапии у больных с ФП. В обзоре приводится информация о различиях эффективности и безопасности отдельных пероральных антикоагулянтов при проведении профилактики тромбоэмболических осложнений ФП у пациентов с СД и нарушением функции почек.
  1. American Diabetes Association. Standards of Medical Care in Diabetes – 2018. Diabetes Care. 2018;41 (Suppl 1):S1–159.
  2. Benjamin EJ, Virani SS, Callaway CW, Chamberlain AM, Chang AR, Cheng S et al. Heart Disease and Stroke Statistics – 2018 Update: A Report From the American Heart Association. Circulation. 2018;137(12):e67–492. DOI:10.1161/CIR.0000000000000558
  3. Naser N, Dilic M, Durak A, Kulic M, Pepic E, Smajic E et al. The Impact of Risk Factors and Comorbidities on The Incidence of Atrial Fibrillation. Materia Socio Medica. 2017;29 (4):231. DOI:10.5455/msm.2017.29.231–236
  4. Rizzo MR , Sasso FC, Marfella R , Siniscalchi M, Paolisso P, Carbonara O et al. Autonomic dysfunction is associated with brief episodes of atrial fibrillation in type 2 diabetes. Journal of Diabetes and its Complications. 2015;29 (1):88–92. DOI:10.1016/j.jdiacomp.2014.09.002
  5. Ziolo MT, Mohler PJ. Defining the Role of Oxidative Stress in Atrial Fibrillation and Diabetes: Editorial Comment. Journal of Cardiovascular Electrophysiology. 2015;26 (2):223–5. DOI:10.1111/jce.12560
  6. Fatemi O, Yuriditsky E, Tsioufis C, Tsachris D, Morgan T, Basile J et al. Impact of Intensive Glycemic Control on the Incidence of Atrial Fibrillation and Associated Cardiovascular Outcomes in Patients With Type 2 Diabetes Mellitus (from the Action to Control Cardiovascular Risk in Diabetes Study). The American Journal of Cardiology. 2014;114(8):1217–22. DOI:10.1016/j.amjcard.2014.07.045
  7. Granger CB, Alexander JH, McMurray JJV, Lopes RD, Hylek EM, Hanna M et al. Apixaban versus warfarin in patients with atrial fibrillation. New England Journal of Medicine. 2011;365 (11):981–92. DOI:10.1056/NEJMoa1107039
  8. Goodman SG, Wojdyla DM, Piccini JP, White HD, Paolini JF, Nessel CC et al. Factors Associated With Major Bleeding Events. Journal of the American College of Cardiology. 2014;63 (9):891–900. DOI:10.1016/j.jacc. 2013.11.013
  9. Brambatti M, Darius H, Oldgren J, Clemens A, Noack HH, Brueckmann M et al. Comparison of dabigatran versus warfarin in diabetic patients with atrial fibrillation: Results from the RE‑LY trial. International Journal of Cardiology. 2015;196:127–31. DOI:10.1016/j.ij‑card. 2015.05.141
  10. Ruff CT, Giugliano RP, Braunwald E, Hoffman EB, Deenadayalu N, Ezekowitz MD et al. Comparison of the efficacy and safety of new oral anticoagulants with warfarin in patients with atrial fibrillation: a meta‑analysis of randomised trials. The Lancet. 2014;383 (9921):955–62. DOI:10.1016/S0140–6736 (13) 62343–0
  11. Patti G, Di Gioia G, Cavallari I, Nenna A. Safety and efficacy of non‑vitamin K antagonist oral anticoagulants versus warfarin in diabetic patients with atrial fibrillation: A study‑level meta‑analysis of phase III randomized trials. Diabetes/Metabolism Research and Reviews. 2017;33 (3):e2876. DOI:10.1002/dmrr.2876
  12. Bansilal S, Bloomgarden Z, Halperin JL, Hellkamp AS, Lokhnygina Y, Patel MR et al. Efficacy and safety of rivaroxaban in patients with diabetes and nonvalvular atrial fibrillation: The Rivaroxaban Once‑daily, Oral, Direct Factor Xa Inhibition Compared with Vitamin K Antagonism for Prevention of Stroke and Embolism Trial in Atrial Fibrillation (ROCKET AF Trial). American Heart Journal. 2015;170 (4):675–682. e8. DOI:10.1016/j.ahj. 2015.07.006
  13. Du X, Ninomiya T, de Galan B, Abadir E, Chalmers J, Pillai A et al. Risks of cardiovascular events and effects of routine blood pressure lowering among patients with type 2 diabetes and atrial fibrillation: results of the ADVANCE study. European Heart Journal. 2009;30(9):1128–35. DOI:10.1093/eurheartj/ehp055
  14. Mak K‑H. Coronary and mortality risk of novel oral antithrombotic agents: a meta‑analysis of large randomised trials. BMJ Open. 2012;2 (5):e001592. DOI:10.1136/bmjopen‑2012–001592
  15. Afkarian M, Sachs MC, Kestenbaum B, Hirsch IB, Tuttle KR , Himmelfarb J et al. Kidney Disease and Increased Mortality Risk in Type 2 Diabetes. Journal of the American Society of Nephrology. 2013;24(2):302–8. DOI:10.1681/ASN.2012070718
  16. Hart RG, Eikelboom JW, Brimble KS, McMurtry MS, Ingram AJ. Stroke Prevention in Atrial Fibrillation Patients With Chronic Kidney Disease. Canadian Journal of Cardiology. 2013;29 (7):S71–8. DOI:10.1016/j.cjca.2013.04.005
  17. Kooiman J, van de Peppel WR , van der Meer FJM, Huisman MV. Incidence of chronic kidney disease in patients with atrial fibrillation and its relevance for prescribing new oral antithrombotic drugs. J Thromb Haemost. 2011;9 (8):1652–3. DOI:10.1111/j.1538–7836.2011.04347.x
  18. Olesen JB, Lip GYH, Kamper A‑L, Hommel K, Køber L, Lane DA et al. Stroke and bleeding in atrial fibrillation with chronic kidney disease. New England Journal of Medicine. 2012;367 (7):625–35. DOI:10.1056/NEJMoa1105594
  19. Albertsen IE, Rasmussen LH, Overvad TF, Graungaard T, Larsen TB, Lip GYH. Risk of stroke or systemic embolism in atrial fibrillation patients treated with warfarin: a systematic review and meta‑analysis. Stroke. 2013;44 (5):1329–36. DOI:10.1161/STROKEAHA.113.000883
  20. Bauer A, Limperger V, Nowak‑Göttl U. End‑stage renal disease and thrombophilia: Hämostaseologie. 2015;36 (2):103–7. DOI:10.5482/HAMO‑14‑11‑0063
  21. Lutz J, Jurk K, Schinzel H. Direct oral anticoagulants in patients with chronic kidney disease: patient selection and special considerations. International Journal of Nephrology and Renovascular Disease. 2017; 10:135–43. DOI:10.2147/IJNRD.S105771
  22. Hart RG, Pearce LA, Asinger RW, Herzog CA. Warfarin in atrial fibrillation patients with moderate chronic kidney disease. Clin J Am Soc Nephrol. 2011;6 (11):2599–604. DOI:10.2215/CJN.02400311
  23. Friberg L, Benson L, Lip GYH. Balancing stroke and bleeding risks in patients with atrial fibrillation and renal failure: the Swedish Atrial Fibrillation Cohort study. Eur Heart J. 2015;36 (5):297–306. DOI:10.1093/eurheartj/ehu139
  24. Jun M, James MT, Manns BJ, Quinn RR , Ravani P, Tonelli M et al. The association between kidney function and major bleeding in older adults with atrial fibrillation starting warfarin treatment: population based observational study. BMJ. 2015;350: h246. DOI:10.1136/bmj.h246
  25. Bai Y, Chen H, Yang Y, Li L, Liu X‑Y, Shi X‑B et al. Safety of antithrombotic drugs in patients with atrial fibrillation and non‑end‑stage chronic kidney disease: Meta‑analysis and systematic review. Thrombosis Research. 2016;137:46–52. DOI:10.1016/j.thromres.2015.11.020
  26. Del‑Carpio Munoz F, Gharacholou SM, Munger TM, Friedman PA, Asirvatham SJ, Packer DL et al. Meta‑analysis of renal function on the safety and efficacy of novel oral anticoagulants for atrial fibrillation. Am J Cardiol. 2016;117 (1):69–75. DOI:10.1016/j.amjcard.2015.09.046
  27. Andò G, Capranzano P. Non‑vitamin K antagonist oral anticoagulants in atrial fibrillation patients with chronic kidney disease: A systematic review and network meta‑analysis. Int J Cardiol. 2017;231:162–9. DOI:10.1016/j.ijcard.2016.11.303
  28. Kimachi M, Furukawa TA, Kimachi K, Goto Y, Fukuma S, Fukuhara S. Direct oral anticoagulants versus warfarin for preventing stroke and systemic embolic events among atrial fibrillation patients with chronic kidney disease. Cochrane Kidney and Transplant Group, редактор. Cochrane Database of Systematic Reviews [Интернет]. 2017 [цитируется по 7 июня 2018 г.]; DOI:10.1002/14651858.CD011373.pub2
  29. Connolly SJ, Ezekowitz MD, Yusuf S, Eikelboom J, Oldgren J, Parekh A et al. Dabigatran versus warfarin in patients with atrial fibrillation. New England Journal of Medicine. 2009;361 (12):1139–51. DOI:10.1056/NEJMoa0905561
  30. Patel MR , Mahaffey KW, Garg J, Pan G, Singer DE, Hacke W et al. Rivaroxaban versus warfarin in nonvalvular atrial fibrillation. New England Journal of Medicine. 2011;365 (10):883–91. DOI:10.1056/NEJ‑Moa1009638
  31. Giugliano RP, Ruff CT, Braunwald E, Murphy SA, Wiviott SD, Halperin JL et al. Edoxaban versus warfarin in patients with atrial fibrillation. N Engl J Med. 2013;369 (22):2093–104. DOI:10.1056/NEJ‑Moa1310907
  32. Connolly SJ, Eikelboom J, Joyner C, Diener H‑C, Hart R, Golitsyn S et al. Apixaban in Patients with Atrial Fibrillation. New England Journal of Medicine. 2011;364 (9):806–17. DOI:10.1056/NEJ‑Moa1007432
  33. Hijazi Z, Hohnloser SH, Oldgren J, Andersson U, Connolly SJ, Eikelboom JW et al. Efficacy and safety of dabigatran compared with warfarin in relation to baseline renal function in patients with atrial fibrillation: a RE‑LY (Randomized Evaluation of Long‑term anticoagulation therapy) trial analysis. Circulation. 2014;129 (9):961–70. DOI:10.1161/CIRCULATIONAHA. 113.003628
  34. Hohnloser SH, Hijazi Z, Thomas L, Alexander JH, Amerena J, Hanna M et al. Efficacy of apixaban when compared with warfarin in relation to renal function in patients with atrial fibrillation: insights from the ARISTOTLE trial. European Heart Journal. 2012;33(22):2821–30. DOI:10.1093/eurheartj/ehs274
  35. Лукьянов М. М., Бойцов С. А., Якушин С. С., Марцевич С. Ю., Воробьев А. Н., Загребельный А. В. и др. Диагностика, лечение, сочетанная сердечно‑сосудистая патология и сопутствующие заболевания у больных с диагнозом «фибрилляция предсердий» в условиях реальной амбулаторно‑поликлинической практики (по данным регистра кардиоваскулярных заболеваний РЕКВАЗА). Рациональная Фармакотерапия В Кардиологии. 2014;10 (4):366–77. [Loukianov M. M., Boytsov S. A., Yakushin S. S., et al. Diagnostics, treatment, associated cardiovascular and concomitant non‑cardiac diseases in patients with diagnosis of “atrial fibrillation” in real outpatient practice (according to data of registry of cardiovascular diseases, RECVASA). Ration Pharmacother Cardiol. 2014;10 (4):366–377.]
  36. Fox KAA, Piccini JP, Wojdyla D, Becker RC, Halperin JL, Nessel CC et al. Prevention of stroke and systemic embolism with rivaroxaban compared with warfarin in patients with non‑valvular atrial fibrillation and moderate renal impairment. European Heart Journal. 2011;32 (19):2387–94. DOI:10.1093/eurheartj/ehr342
  37. Sciascia S, Radin M, Schreiber K, Fenoglio R, Baldovino S, Roccatello D. Chronic kidney disease and anticoagulation: from vitamin K antagonists and heparins to direct oral anticoagulant agents. Internal and Emergency Medicine. 2017;12 (8):1101–8. DOI:10.1007/s11739‑017‑1753‑2
  38. Harel Z, Sood MM, Perl J. Comparison of novel oral anticoagulants versus vitamin K antagonists in patients with chronic kidney disease: Current Opinion in Nephrology and Hypertension. 2015;24 (2):183–92. DOI:10.1097/MNH.0000000000000098
  39. Steffel J, Verhamme P, Potpara TS, Albaladejo P, Antz M, Desteghe L et al. The 2018 European Heart Rhythm Association Practical Guide on the use of non‑vitamin K antagonist oral anticoagulants in patients with atrial fibrillation. European Heart Journal. 2018;39 (16):1330–93. DOI:10.1093/eurheartj/ehy136
  40. Kirchhof P, Benussi S, Kotecha D, Ahlsson A, Atar D, Casadei B et al. 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS. European Heart Journal. 2016;37(38):2893–962. DOI:10.1093/eurheartj/ehw210
  41. Моисеев В. С., Мухин Н. А., Смирнов А. В., Кобалава Ж. Д., Бобкова И. Н., Виллевальде С. В. et al. Сердечно‑сосудистый риск и хроническая болезнь почек: стратегии кардионефропротекции. Российский кардиологический журнал. 2014;8:7–37. [Moiseev V. S., Mukhin N. A., Smirnov A. V., Kobalava J. D., Bobkova I. N., Villevalde S. V. et al. Cardiovascular risk and chronic kidney disease: cardionephroprotection strategies. Russian Journal of Cardiology. 2014;8:7–37.] DOI:10.15829/1560‑4071‑2014‑8‑7‑37
  42. Roldán V, Marín F, Fernández H, Manzano‑Fernández S, Gallego P, Valdés M et al. Renal impairment in a “real‑life” cohort of anticoagulated patients with atrial fibrillation (implications for thromboembolism and bleeding). Am J Cardiol. 2013;111 (8):1159–64. DOI:10.1016/j.amjcard. 2012.12.045
  43. DiNicolantonio JJ, Bhutani J, O’Keefe JH. The health benefits of vitamin K. Open Heart. 2015;2 (1):e000300. DOI:10.1136/openhrt‑2015–000300
  44. Narasimha Krishna V, Warnock DG, Saxena N, Rizk DV. Oral Anticoagulants and Risk of Nephropathy. Drug Safety. 2015;38 (6):527–33. DOI:10.1007/s40264‑015‑0290‑z
  45. Fanola CL, Mooney D, Cowan AJ, Ko D, Sisson EK, Henault LE et al. Incidence of severe renal dysfunction among individuals taking warfarin and implications for non – vitamin K oral anticoagulants. American Heart Journal. 2017;184:150–5. DOI:10.1016/j.ahj.2016.08.017
  46. Caldeira D, Gonçalves N, Pinto FJ, Costa J, Ferreira JJ. Risk of renal failure with the non‑vitamin K antagonist oral anticoagulants: systematic review and meta‑analysis: NOACS AND INCIDENCE OF RE‑NAL FAILURE. Pharmacoepidemiology and Drug Safety. 2015;24 (7):757–64. DOI:10.1002/pds.3791
  47. Fordyce CB, Hellkamp AS, Lokhnygina Y, Lindner SM, Piccini JP, Becker RC et al. On‑Treatment Outcomes in Patients With Worsening Renal Function With Rivaroxaban Compared With Warfarin Clinical Perspective: Insights From ROCKET AF. Circulation. 2016;134(1):37–47. DOI:10.1161/CIRCULATIONAHA.116.021890
  48. Böhm M, Ezekowitz MD, Connolly SJ, Eikelboom JW, Hohnloser SH, Reilly PA et al. Changes in renal function in patients with atrial fibrillation. Journal of the American College of Cardiology. 2015;65 (23):2481–93. DOI:10.1016/j.jacc. 2015.03.577
  49. Hijazi Z, Hohnloser SH, Andersson U, Alexander JH, Hanna M, Keltai M et al. Efficacy and Safety of Apixaban Compared With Warfarin in Patients With Atrial Fibrillation in Relation to Renal Function Over Time: Insights From the ARISTOTLE Randomized Clinical Trial. JAMA Cardiology. 2016;1(4):451. DOI:10.1001/jamacardio.2016.1170
Канорский С. Г. Антикоагулянтная терапия у больных с фибрилляцией предсердий в особых ситуациях: сахарный диабет, хроническая болезнь почек. Кардиология. 2018;58(S7):4–10

Для доступа к данному материалу пожалуйста авторизуйтесь или зарегистрируйтесь

Зарегистрируйтесь Авторизуйтесь
Ru En