EFFICACY AND SAFETY OF ANTI-COGULAR TREATMENT IN PATIENTS WITH FIBRILLATION OF ATRIAL IN REAL CLINICAL PRACTICE

• Published in: Медицина в Кузбассе Vol. 18; no. 3; pp. 36 - 40
• Main Authors: Николай Андреевич Бичан, Наталья Александровна Трофименко, Дарья Дмитриевна Золотарева, Марина Владимировна Поцелуева, Ирина Юрьевна Баркова, Юлия Владиславовна Ковалева, Ольга Геннадьевна Елдинова
• Format: Journal Article
• Language: Russian
• Published: The Publishing House Medicine and Enlightenment 01.10.2019
• Subjects: апискабан; варфарин; дабигатран; ишемический инсульт; кровотечения; ривароксабан; фибрилляция предсердий
• ISSN: 1819-0901

In 127 patients with atrial fibrillation (AF), the efficacy and safety of anticoagulant treatment for 12 months was studied. The mean age of patients was 69.9 ± 1.2 years, 41.7% were older than 75 years, and 20% had GFR <40 ml / min / 1.73 m2. The average CHA2DS2-VASc was 4.0, the average HAS- BLED is 1.8. 24 patients took dabigatran (Pradaхa) at a dose of 110-150 mg 2 times a day, 25 - apixaban (Eliquis) at a dose of 2.5-5 mg 2 times a day, 39 - rivaroxaban (Xarеlto) 20 mg per day and 39 - warfarin dose ensuring the maintenance of INR at the level of 1.8-2.5. It is proved that all three PLA are effective in preventing strokes with non-valvular AF in comparison with warfarin. The HR of stroke development in comparison with warfarin for dabigatran was 0.54, for apixaban – 0.41 and for rivaroxaban – 0.37. The risk of bleeding for dabigatran D 0.25, for apixaban – 0.04, for rivaroxaban – 0.18. Low risk of bleeding was associated with taking apaxaban at a dose of 2,5 mg 2 times a day and pradaxa 110 mg 2 times a day in individuals ≤ 75 years and/or having GFR<40 ml/min/1,73m2. Logistic regression revealed that the most significant factors for stroke development were age over 75 years, GFR below 40 ml/min/1,73m2 and the presence of previous strokes in history. For the risk of bleeding, significant risk factors were age over 75 years and GFR <40 ml/min/1,73m2.