On the issue of improving the safety of antithrombotic therapy in patients with atrial fibrillation and coronary heart disease receiving antithrombotic therapy

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Abstract

Today, the burden of atrial fibrillation (AF) and coronary heart disease (CHD) increases with increasing life expectancy. For patients with a combination of these diseases, in certain clinical situations, combination therapy with anticoagulant and antiplatelet drugs is indicated, which increases the risk of adverse events and complications, in particular gastrointestinal bleeding (GIB). To reduce the risk of complications from the gastrointestinal tract, it is recommended to identify modifiable and non-modifiable risk factors, as well as prescribe gastroprotective therapy to protect the mucous membrane of the gastrointestinal tract. Considering the peculiarities of the mechanism of action, pharmacokinetics and pharmacodynamics, the gastroprotective drug rebamipide has both high safety and significant effectiveness due to multiple pleiotropic actions (changes in the structure of tight junctions of mucosal enterocytes, stimulation of mucin formation, acceleration of cell regeneration, etc.). In real clinical practice, according to our studies, a significant number of patients did not have gastroprotective therapy or only monotherapy with proton pump inhibitors (PPIs), which indicates the need to increase the awareness of practicing physicians about methods of reducing the risk of gastrointestinal complications in patients with AF and CHD. In summary, prevention of gastrointestinal and gastrointestinal mucosal damage is critical for long-term antithrombotic therapy in cardiac patients.

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About the authors

Olga D. Ostroumova

Russian Medical Academy of Continuous Professional Education; I.M. Sechenov First Moscow State Medical University (Sechenov University)

Email: ostroumova.olga@mail.ru
ORCID iD: 0000-0002-0795-8225
SPIN-code: 3910-6585

Dr. Sci. (Med.), Professor, Head of the Department of Therapy and Polymorbid Pathology n.a. Academician M.S. Vovsin, Professor of the Department of Clinical Pharmacology and Propaedeutics of Internal Diseases

Russian Federation, Moscow; Moscow

A. V. Dubinina

Russian Medical Academy of Continuous Professional Education

Email: ostroumova.olga@mail.ru
ORCID iD: 0009-0008-6383-0016
Russian Federation, Moscow

V. A. De

Russian Medical Academy of Continuous Professional Education

Email: ostroumova.olga@mail.ru
ORCID iD: 0000-0002-3900-758X
SPIN-code: 1817-6115
Russian Federation, Moscow

A. I. Kochetkov

Russian Medical Academy of Continuous Professional Education

Author for correspondence.
Email: ostroumova.olga@mail.ru
ORCID iD: 0000-0001-5801-3742
SPIN-code: 9212-6010
Russian Federation, Moscow

V. B. Dashabylova

Russian Medical Academy of Continuous Professional Education

Email: ostroumova.olga@mail.ru
ORCID iD: 0000-0002-8926-6731
Russian Federation, Moscow

S. S. Eremina

Russian Medical Academy of Continuous Professional Education

Email: ostroumova.olga@mail.ru
ORCID iD: 0000-0001-7989-354X
Russian Federation, Moscow

M. V. Klepikova

Russian Medical Academy of Continuous Professional Education

Email: ostroumova.olga@mail.ru
ORCID iD: 0000-0003-4258-1889
Russian Federation, Moscow

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