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№2' 2014

CARDIOLOGY

International Medical Journal, Vol. 20., Iss. 2, 2014, P. 9−19.


ANTIPLATELET AND ANTICOAGULANT THERAPY IN PATIENTS WITH NON-VALVE ATRIAL FIBRILLATION


Dolgova E. L., Sokolov I. M., Schwartz Yu. G.

V.I. Razumovsky Saratov State Medical University, Ministry of Health of Russian Federation, Russian Federation

Atrial fibrillation is the most common type of arrhythmia in the clinical practice. It is responsible for one third of admissions for heart rhythm disorders and is associated with increased risk of death, stroke, and other thromboembolic complications. The authors review non−valve atrial fibrillation in which thromboembolic complications occur due to thrombosis of the left atrium, mainly its auricle. Antiaggregants and anticoagulants are used among the other drugs to prevent these complications. In the patients with intermediate and high risk, antiaggregants have some advantages over aspirin or aspirin/clopidogrel. Anticoagulant therapy with adjusted doses of warfarin is the most accessible strategy to prevent stroke in patients with atrial fibrillation. The search for new oral anticoagulants, which are effective, safe and easy to use, is aimed at direct thrombin inhibitors and factor Xa inhibitors (apixaban, rivaroxaban). Introduction of a new generation of anticoagulants is a step forward and can allow increase in the number of patients receiving an adequate prevention of thromboembolic complications.

Key words: atrial fibrillation, thromboembolic complications, anticoagulant therapy, warfarin, apixaban, rivaroxaban, dabigatran.


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