MANAGEMENT OF PATIENTS WITH NON-VALVULAR ATRIAL FIBRILLATION IN THE SETTINGS OF ANTICOAGULANT THERAPY CONTROL OFFICE: PROLONGED EFFECTIVE AND SAFE USE OF ANTICOAGULATION
- Authors: Sokolova A.A1, Tsarev I.L1, Napalkov D.A1, Sulimov V.A1
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Affiliations:
- SBEI HPE «First MSMU n.a. I.M. Sechenov» of RMPH
- Issue: No 6 (2016)
- Pages: 45-50
- Section: Articles
- URL: https://journals.eco-vector.com/2073-4034/article/view/288791
- ID: 288791
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Abstract
The study was aimed to the identification of adverse factors of use of anticoagulant therapy (ACT) for the selection of patient’s groups at high risk of bleeding during treatment with oral anticoagulants. The research is conducted on the basis of the University Clinical Hospital № 1 First MSMU n.a. I.M. Sechenov and includes 325 patients with non-valvular atrial fibrillation receiving various ACT for the prevention of thromboembolic complications (TEC). Mean duration of follow-up period - 24 months. Among 325 patients included in the study, more than 95% of patients continue to receive anticoagulants and continue monitoring in anticoagulant therapy control office. A total of 37 bleeds were recorded, including 19 «small» and 18 «major». In most cases, bleeding complications were detected in patients with CHA2DS2-VASc scores= 1, 4 and 8, and HAS-BLED scores=4. In patients with history of acute cerebrovascular accidents (ACVA), bleedings have occurred significantly more often than in patients without ACVA. Number of major bleedings in patients on warfarin was significantly higher than in patients on oral anticoagulants, and the number of small bleedings in patients on warfarin was significantly lower (p<0.05). It should be noted that the frequency of major bleedings on warfarin was significantly higher than on any of the new oral anticoagulants - dabigatran, rivaroxaban, and apixaban. During follow-up period, TECs were observed only in 3 patients (0.9% of the total number receiving ACT). It is emphasized that the effective and safe ACT requires systematic monitoring of patients receiving this type of therapy. The most optimal way to monitor this patient cohort is considered to be anticoagulation therapy control office.
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About the authors
A. A Sokolova
SBEI HPE «First MSMU n.a. I.M. Sechenov» of RMPH
I. L Tsarev
SBEI HPE «First MSMU n.a. I.M. Sechenov» of RMPH
D. A Napalkov
SBEI HPE «First MSMU n.a. I.M. Sechenov» of RMPH
Email: dminap@mail.ru
V. A Sulimov
SBEI HPE «First MSMU n.a. I.M. Sechenov» of RMPH
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