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Dynamics of Prescribing Antithrombotic Therapy to Patients with Atrial Fibrillation Hospitalized for Myocardial Infarction in 2016–2021
- Authors: Korshikova A.A.1, Pereverzeva K.G.1, Yakushin S.S.1
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Affiliations:
- Ryazan State Medical University
- Issue: Vol 31, No 3 (2023)
- Pages: 405-414
- Section: Original study
- URL: https://journals.eco-vector.com/pavlovj/article/view/109417
- DOI: https://doi.org/10.17816/PAVLOVJ109417
- ID: 109417
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Abstract
INTRODUCTION: At present, the issue of optimal antithrombotic therapy (ATT) in patients with myocardial infarction (MI) and atrial fibrillation (AF) has not been finally resolved, it requires an individual approach and is of interest for study.
AIM: To study the dynamics of prescribing ATT to patients with AF of non-valvular etiology hospitalized in cardiology hospital in 2016–2021 for MI.
MATERIALS AND METHODS: The study included 599 patients with MI and AF: in 2016–2017 — 104 patients, in 2018–2019 — 256 patients, in 2020–2021 — 239 patients. The median and interquartile range of age of patients hospitalized in 2016–2017 were 70 (61.0; 78.0) years, in 2018–2019 — 71 (65.0; 79.3) years, in 2020–2021 — 72 (65.0; 80.0) years, p = 0.09.
RESULTS: In 2016–2017, 76.9% of patients with MI and AF were prescribed double antiplatelet therapy (DAPT) from the first day of hospitalization; 16.3% of patients were prescribed therapy with oral anticoagulants (OACs), here, in 6.7% — as part of triple ATT, in 8.7% — as part of double ATT (OACs + antiplatelet agent), in 1.0% — as monotherapy with OACs; in 3.8% monotherapy with an antiplatelet agent was prescribed; in 2.9% of cases ATT was not prescribed. In 2018–2019, DAPT was used in 37.9% of cases; therapy with OACs — in 54.7% of cases: in 44.9% cases as part of triple ATT, in 9.8% as part of double therapy; in 7.4% of cases monotherapy with antiplatelet agent was prescribed. In 2020–2021, DAPT was prescribed in 15.9% of cases; therapy with OACs in 74.5%, of them in 59.8% — triple АТТ, in 14.2% — double АТТ; monotherapy with an antiplatelet agent - in 7.5%; in 1.7% АТТ was not prescribed.
CONCLUSION: In the study, the frequency of prescription of triple ATT to patients with AF and MI in 2020–2021 increased 1.3 times as compared to 2018–2019, and 8.9 times as compared to 2016–2017 and made 59.8% (p < 0.001 for all periods). The frequency of OAC also increased 1.3 times as compared to 2018–2019 and 4.6 times as compared to 2016–2017 and made 74.5% (p < 0.001 for all periods). This dynamics of increase in the frequency of prescription of oral anticoagulants to patients with a combination of AF and MI should be considered a positive result of introduction of the Clinical recommendations in the treatment of cardiologic patients.
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About the authors
Anastasiya A. Korshikova
Ryazan State Medical University
Author for correspondence.
Email: nastasya.korshikova@mail.ru
ORCID iD: 0000-0001-7041-4979
SPIN-code: 8423-7071
Russian Federation, Ryazan
Kristina G. Pereverzeva
Ryazan State Medical University
Email: pereverzevakg@gmail.com
ORCID iD: 0000-0001-6141-8994
SPIN-code: 4995-1465
ResearcherId: I-3658-2018
MD, Dr. Sci. (Med.), Associate Professor
Russian Federation, RyazanSergey S. Yakushin
Ryazan State Medical University
Email: ssyakushin@yandex.ru
ORCID iD: 0000-0002-1394-3791
SPIN-code: 7726-7198
MD, Dr. Sci. (Med.), Professor
Russian Federation, RyazanReferences
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