Anticoagulant Therapy in Difficult Patients with Atrial Fibrillation: When the Risks of Embolism and Bleeding Are Comparable
This article affects the problems of using NOAC in the most defenseless groups of patients with atrial fibrillation: those who have high bleeding and high thromboembolic risk and elderly. The focus is on comparison of effectiveness and safety of NOACs based on randomized clinical trials (RCT) an...
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| Format: | Article |
| Language: | English |
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Столичная издательская компания
2018-11-01
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| Series: | Рациональная фармакотерапия в кардиологии |
| Subjects: | |
| Online Access: | https://www.rpcardio.online/jour/article/view/1769 |
| _version_ | 1797232187369586688 |
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| author | D. A. Napalkov A. A. Sokolova M. A. Gabitova L. N. Uddin |
| author_facet | D. A. Napalkov A. A. Sokolova M. A. Gabitova L. N. Uddin |
| author_sort | D. A. Napalkov |
| collection | DOAJ |
| description | This article affects the problems of using NOAC in the most defenseless groups of patients with atrial fibrillation: those who have high bleeding and high thromboembolic risk and elderly. The focus is on comparison of effectiveness and safety of NOACs based on randomized clinical trials (RCT) and real-world data (RWD). The possible reasons for the different interpretation of the data of the RCT and the RWD are shown. Use of NOAC in reduced doses prescribing according to RCT and RWD are shown. Our own 13-month observation of patients 75 years and older with very high thromboembolic risk (CHA2DS2-VASc – 4,5 points) on rivaroxaban therapy are presented. Good efficacy and safety of full and reduced doses of rivaroxaban were demonstrated: only 2 episodes of small bleedings and no large bleedings (ISTH criteria) were detected as well as no thromboembolic events. Thus, even difficult patients with AF and comorbidity may be safely and effectively treated with NOACs taking into consideration integrated approach and correction of modifiable risk factors. |
| first_indexed | 2024-03-08T14:02:31Z |
| format | Article |
| id | doaj.art-d2bd3467fab94ca0b8c14838a1937e77 |
| institution | Directory Open Access Journal |
| issn | 1819-6446 2225-3653 |
| language | English |
| last_indexed | 2024-04-24T15:56:17Z |
| publishDate | 2018-11-01 |
| publisher | Столичная издательская компания |
| record_format | Article |
| series | Рациональная фармакотерапия в кардиологии |
| spelling | doaj.art-d2bd3467fab94ca0b8c14838a1937e772024-04-01T07:43:37ZengСтоличная издательская компанияРациональная фармакотерапия в кардиологии1819-64462225-36532018-11-0114578578910.20996/1819-6446-2018-14-5-785-7891537Anticoagulant Therapy in Difficult Patients with Atrial Fibrillation: When the Risks of Embolism and Bleeding Are ComparableD. A. Napalkov0A. A. Sokolova1M. A. Gabitova2L. N. Uddin3I.M. Sechenov First Moscow State Medical University (Sechenov University)I.M. Sechenov First Moscow State Medical University (Sechenov University)I.M. Sechenov First Moscow State Medical University (Sechenov University)I.M. Sechenov First Moscow State Medical University (Sechenov University)This article affects the problems of using NOAC in the most defenseless groups of patients with atrial fibrillation: those who have high bleeding and high thromboembolic risk and elderly. The focus is on comparison of effectiveness and safety of NOACs based on randomized clinical trials (RCT) and real-world data (RWD). The possible reasons for the different interpretation of the data of the RCT and the RWD are shown. Use of NOAC in reduced doses prescribing according to RCT and RWD are shown. Our own 13-month observation of patients 75 years and older with very high thromboembolic risk (CHA2DS2-VASc – 4,5 points) on rivaroxaban therapy are presented. Good efficacy and safety of full and reduced doses of rivaroxaban were demonstrated: only 2 episodes of small bleedings and no large bleedings (ISTH criteria) were detected as well as no thromboembolic events. Thus, even difficult patients with AF and comorbidity may be safely and effectively treated with NOACs taking into consideration integrated approach and correction of modifiable risk factors.https://www.rpcardio.online/jour/article/view/1769atrial fibrillationdifficult patientselderlyrivaroxabanwarfarin |
| spellingShingle | D. A. Napalkov A. A. Sokolova M. A. Gabitova L. N. Uddin Anticoagulant Therapy in Difficult Patients with Atrial Fibrillation: When the Risks of Embolism and Bleeding Are Comparable Рациональная фармакотерапия в кардиологии atrial fibrillation difficult patients elderly rivaroxaban warfarin |
| title | Anticoagulant Therapy in Difficult Patients with Atrial Fibrillation: When the Risks of Embolism and Bleeding Are Comparable |
| title_full | Anticoagulant Therapy in Difficult Patients with Atrial Fibrillation: When the Risks of Embolism and Bleeding Are Comparable |
| title_fullStr | Anticoagulant Therapy in Difficult Patients with Atrial Fibrillation: When the Risks of Embolism and Bleeding Are Comparable |
| title_full_unstemmed | Anticoagulant Therapy in Difficult Patients with Atrial Fibrillation: When the Risks of Embolism and Bleeding Are Comparable |
| title_short | Anticoagulant Therapy in Difficult Patients with Atrial Fibrillation: When the Risks of Embolism and Bleeding Are Comparable |
| title_sort | anticoagulant therapy in difficult patients with atrial fibrillation when the risks of embolism and bleeding are comparable |
| topic | atrial fibrillation difficult patients elderly rivaroxaban warfarin |
| url | https://www.rpcardio.online/jour/article/view/1769 |
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