Anticoagulant therapy for non-valvular atrial fibrillation patients with CHA2DS2-VASc (regardless of gender): a personalized approach based on risk/benefit analysis

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Abstract

Initiation of oral anticoagulant therapy in patients with non-valvular atrial fibrillation and a CHA2DS2-VASc score of 1 in male and 2 in female patients is a point of difficult choice in clinical practice. Therapeutic decisions in this group of intermediate-risk patients should provide a balance between the individual benefit of reducing the risk of thromboembolism and potential harm due to increased risk of bleeding. Article summarizes the currently available data on antithrombotic treatment of patients in such clinical group. Additional factors which need to be necessarily considered in the personalized estimation of individual risk of thromboembolism in patients with atrial fibrillation, to decide on the initiation of anticoagulant therapy are discussed.

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About the authors

Tatyana V. Adasheva

A.I. Yevdokimov Moscow State University of Medicine and Dentistry of the Ministry of Healthcare of Russia

Author for correspondence.
Email: adashtv@mail.ru
ORCID iD: 0000-0002-3763-8994

MD, professor, professor of the Department of therapy and preventive medicine

Russian Federation, Moscow

Elena I. Samorukova

A.I. Yevdokimov Moscow State University of Medicine and Dentistry of the Ministry of Healthcare of Russia

Email: wlrad@bk.ru
ORCID iD: 0000-0002-8912-1348

PhD in Medical Sciences, assistant at the Department of polyclinic therapy

Russian Federation, Moscow

Ekaterina E. Gubernatorova

A.I. Yevdokimov Moscow State University of Medicine and Dentistry of the Ministry of Healthcare of Russia

Email: creativone@list.ru
ORCID iD: 0009-0009-4149-9497

PhD in Medical Sciences, assistant at the Department of polyclinic therapy

Russian Federation, Moscow

Elena G. Lobanova

A.I. Yevdokimov Moscow State University of Medicine and Dentistry of the Ministry of Healthcare of Russia

Email: e.g.lobanova@mail.ru
ORCID iD: 0000-0002-5815-2942

MD, professor of the Department of pharmacology

Russian Federation, Moscow

Natalya B. Shakhrai

A.I. Yevdokimov Moscow State University of Medicine and Dentistry of the Ministry of Healthcare of Russia

Email: nholodkova@mail.ru
ORCID iD: 0000-0002-4223-1064

PhD in Medical Sciences, associate professor of the Department of therapy and preventive medicine

Russian Federation, Moscow

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2. Fig.1. Association of Atrial Fibrillation Workload with Risk of Stroke*

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3. Fig.2. Algorithm for making a decision on the appointment of oral anticoagulants in patients with atrial fibrillation with a CHA2DS2-VASC score of 1 point

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