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Фибрилляция предсердий в старческом возрасте: управление рисками и особенности применения прямых пероральных антикоагулянтов

https://doi.org/10.18087/cardio.2021.6.n1627

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Аннотация

Больные с фибрилляцией предсердий (ФП) старческого возраста подвержены большему риску тромбоэмболии и кровотечения, чем более молодые пациенты. Три прямых пероральных антикоагулянта (ПОАК) – апиксабан, дабигатран и ривароксабан зарегистрированы в Российской Федерации и широко назначаются для предотвращения инсульта у пациентов с ФП. Применение ПОАК у больных с ФП старческого возраста требует учета особенностей пациентов, клинических ситуаций и свойств отдельных препаратов для достижения баланса эффективности и безопасности, комплексной защиты при проведении антикоагулянтной терапии. Согласно исследованиям реальной клинической практики ПОАК могут иметь преимущества в сравнении с варфарином (снижение риска переломов, сахарного диабета, деменции). Приверженность и постоянство лечения ПОАК важны для обеспечения его результативности, особенно у людей старческого возраста. Результаты клинических исследований и исследований реальной клинической практики подтверждают, что ривароксабан может создавать комплексную защиту пожилого пациента с ФП, которая обеспечивается благоприятными показателями эффективности и безопасности, положительным влиянием на риски коронарных событий и риски ухудшения функции почек, а дозирование ривароксабана 1 раз в сутки способствует улучшению приверженности лечению и постоянству терапии.

Об авторе

С. Г. Канорский
ФГБОУ ВО «Кубанский государственный медицинский университет» Минздрава РФ, Краснодар, Россия
Россия

заведующий кафедрой терапии №2 ФПК и ППС



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Для цитирования:


Канорский С.Г. Фибрилляция предсердий в старческом возрасте: управление рисками и особенности применения прямых пероральных антикоагулянтов. Кардиология. 2021;61(6):79-87. https://doi.org/10.18087/cardio.2021.6.n1627

For citation:


Kanorskii S.G. Atrial fibrillation in old age: risk management and features of the use of direct oral anticoagulants. Kardiologiia. 2021;61(6):79-87. (In Russ.) https://doi.org/10.18087/cardio.2021.6.n1627

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