The risk of bleeding minimization with direct oral anticoagulants
This review is devoted to the safety issues of anticoagulant therapy prescribed for the prevention of stroke and systemic embolism in patients with atrial fibrillation. Direct oral anticoagulants are considered worldwide in accordance with the guidelines for the diagnosis and treatment of atrial fib...
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| Format: | Article |
| Language: | Russian |
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«REMEDIUM GROUP» Ltd.
2021-07-01
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| Series: | Атеротромбоз |
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| Online Access: | https://www.aterotromboz.ru/jour/article/view/247 |
| _version_ | 1797883889241292800 |
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| author | Т. N. Novikova |
| author_facet | Т. N. Novikova |
| author_sort | Т. N. Novikova |
| collection | DOAJ |
| description | This review is devoted to the safety issues of anticoagulant therapy prescribed for the prevention of stroke and systemic embolism in patients with atrial fibrillation. Direct oral anticoagulants are considered worldwide in accordance with the guidelines for the diagnosis and treatment of atrial fibrillation as the preferred anticoagulant choice for the prevention of stroke and systemic embolism. Direct oral anticoagulants in comparison with vitamin K antagonists generally have similar efficacy, but different safety profiles, primarily, this concerns the risk of large extracranial and, primarily, gastrointestinal hemorrhages. To minimize the risk of bleeding during therapy with direct oral anticoagulants, an individual approach to the choice of the drug for each individual patient is required after assessing the risk of bleeding, searching for a potential bleeding substrate, correcting existing risk factors and eliminating, if possible, the substrate. When choosing an anticoagulant therapy, special attention should be paid to the most vulnerable categories of patients, such as patients of older age groups and patients with concomitant chronic kidney disease. Among the direct oral anticoagulants registered in the Russian Federation, according to meta-analyzes of key randomized clinical trials and real clinical trials, apixaban has the most optimal benefit: risk ratio in a wide range of patients, including vulnerable populations. Dynamic observation, including regular assessment of renal function, control of clinical blood analysis, erythrocyte and platelet levels, after prescribing an individually selected anticoagulant to the patient, ensures the maximum safety of therapy. Small, so-called, annoying bleeding is not a reason for canceling the anticoagulant, but requires a careful search for the causes of bleeding and their correction. |
| first_indexed | 2024-04-10T03:58:56Z |
| format | Article |
| id | doaj.art-00dcd2f616ac4a38896481d3471efd5b |
| institution | Directory Open Access Journal |
| issn | 2307-1109 2658-5952 |
| language | Russian |
| last_indexed | 2024-04-10T03:58:56Z |
| publishDate | 2021-07-01 |
| publisher | «REMEDIUM GROUP» Ltd. |
| record_format | Article |
| series | Атеротромбоз |
| spelling | doaj.art-00dcd2f616ac4a38896481d3471efd5b2023-03-13T07:10:43Zrus«REMEDIUM GROUP» Ltd.Атеротромбоз2307-11092658-59522021-07-010110612610.21518/2307-1109-2021-11-1-106-126216The risk of bleeding minimization with direct oral anticoagulantsТ. N. Novikova0Северо-Западный государственный медицинский университет имени И.И. МечниковаThis review is devoted to the safety issues of anticoagulant therapy prescribed for the prevention of stroke and systemic embolism in patients with atrial fibrillation. Direct oral anticoagulants are considered worldwide in accordance with the guidelines for the diagnosis and treatment of atrial fibrillation as the preferred anticoagulant choice for the prevention of stroke and systemic embolism. Direct oral anticoagulants in comparison with vitamin K antagonists generally have similar efficacy, but different safety profiles, primarily, this concerns the risk of large extracranial and, primarily, gastrointestinal hemorrhages. To minimize the risk of bleeding during therapy with direct oral anticoagulants, an individual approach to the choice of the drug for each individual patient is required after assessing the risk of bleeding, searching for a potential bleeding substrate, correcting existing risk factors and eliminating, if possible, the substrate. When choosing an anticoagulant therapy, special attention should be paid to the most vulnerable categories of patients, such as patients of older age groups and patients with concomitant chronic kidney disease. Among the direct oral anticoagulants registered in the Russian Federation, according to meta-analyzes of key randomized clinical trials and real clinical trials, apixaban has the most optimal benefit: risk ratio in a wide range of patients, including vulnerable populations. Dynamic observation, including regular assessment of renal function, control of clinical blood analysis, erythrocyte and platelet levels, after prescribing an individually selected anticoagulant to the patient, ensures the maximum safety of therapy. Small, so-called, annoying bleeding is not a reason for canceling the anticoagulant, but requires a careful search for the causes of bleeding and their correction.https://www.aterotromboz.ru/jour/article/view/247фибрилляция предсердийантикоагулянтная терапиябольшие кровотечениядосаждающие кровотечениябезопасность антикоагулянтной терапии |
| spellingShingle | Т. N. Novikova The risk of bleeding minimization with direct oral anticoagulants Атеротромбоз фибрилляция предсердий антикоагулянтная терапия большие кровотечения досаждающие кровотечения безопасность антикоагулянтной терапии |
| title | The risk of bleeding minimization with direct oral anticoagulants |
| title_full | The risk of bleeding minimization with direct oral anticoagulants |
| title_fullStr | The risk of bleeding minimization with direct oral anticoagulants |
| title_full_unstemmed | The risk of bleeding minimization with direct oral anticoagulants |
| title_short | The risk of bleeding minimization with direct oral anticoagulants |
| title_sort | risk of bleeding minimization with direct oral anticoagulants |
| topic | фибрилляция предсердий антикоагулянтная терапия большие кровотечения досаждающие кровотечения безопасность антикоагулянтной терапии |
| url | https://www.aterotromboz.ru/jour/article/view/247 |
| work_keys_str_mv | AT tnnovikova theriskofbleedingminimizationwithdirectoralanticoagulants AT tnnovikova riskofbleedingminimizationwithdirectoralanticoagulants |