TherapyTherapyТерапия2412-40362713-1823Bionika Media69411510.18565/therapy.2025.7.72-79REVIEWSОБЗОРЫReview ArticleEvidentiary basis of anticoagulant therapy in case of atrial fibrillation and diabetes mellitus combinationДоказательная база антикоагулянтной терапии при сочетании фибрилляции предсердий и сахарного диабетаhttps://orcid.org/0000-0003-1510-92047635-5330KanorskySergey G.КанорскийСергей Григорьевич
Russian Federation

MD, Dr. Sci. (Medicine), professor, head of the Department of therapy No. 2

д. м. н., профессор, заведующий кафедрой терапии № 2

kanorskysg@mail.ruKuban State Medical University of the Ministry of Healthcare of RussiaФГБОУ ВО «Кубанский государственный медицинский университет» Минздрава России2410202511772792310202523102025Copyright ©; 2025, “Bionika Media” LLCCopyright ©; 2025, ООО «Бионика Медиа»2025“Bionika Media” LLCООО «Бионика Медиа»https://journals.eco-vector.com/2412-4036/about/editorialPolicieshttps://journals.eco-vector.com/2412-4036/article/view/694115

Oral anticoagulant therapy is a convincingly proven method for reducing mortality in patients with atrial fibrillation (AF). However, until the present, no special randomized clinical trials of oral anticoagulants in patients with combination of AF and diabetes mellitus (DM) with an assessment of clinical outcomes have been performed.

The aim of the review is to analyze current literature data on the efficacy and safety of oral anticoagulants with a focus on rivaroxaban for a substantiated choice of tactics for their use in patients with AF and DM combination. Literature search was performed in electronic databases eLibrary.ru and PubMed to identify articles published from 2015 to 2025. The review presents pathophysiological correlation between AF and diabetes mellitus, options for anticoagulant therapy in patients with a combination of these diseases, and the results of the most important comparative studies of oral anticoagulants in the treatment of such kind of patients. Influence of individual options of anticoagulant therapy at renal function is also compared, and a number of advantages of direct oral anticoagulants comparatively to warfarin are discussed.

Пероральная антикоагулянтная терапия – убедительно доказанный способ снижения смертности пациентов с фибрилляцией предсердий (ФП). Однако до сих пор не проводилось специальных рандомизированных клинических исследований пероральных антикоагулянтов у больных с сочетанием ФП и сахарного диабета (СД) с оценкой клинических исходов.

Цель обзора – проанализировать современные литературные данные об эффективности и безопасности пероральных антикоагулянтов с фокусом на ривароксабан для обоснованного выбора тактики их применения у больных с сочетанием ФП и СД. Поиск литературных источников проводился в электронных базах eLibrary.ru и PubMed для выявления статей, опубликованных с 2015 по 2025 г. В обзоре представлены патофизиологическая связь ФП и СД, варианты антикоагулянтной терапии у пациентов с сочетанием этих заболеваний, результаты важнейших сравнительных исследований пероральных антикоагулянтов при лечении таких пациентов. Также сопоставлено влияние отдельных вариантов антикоагулянтной терапии на функцию почек, обсужден ряд преимуществ прямых пероральных антикоагулянтов в сравнении с варфарином.

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