Отдельные группы лекарственных средств, прием которых ассоциирован с развитием лекарственно-индуцированной фибрилляции предсердий

Последнее время все больше внимания уделяется проблеме лекарственно‑индуцированной (ЛИ) фибрилляции предсердий (ФП). Известно, что развитие ЛИ ФП может быть ассоциировано с приемом сердечно‑сосудистых и противоопухолевых лекарственных средств (ЛС), ЛС, влияющих на центральную нервную систему или органы дыхания. Однако имеются и другие ЛС, которые могут провоцировать ЛИ ФП, о чем практикующие врачи осведомлены в гораздо меньшей степени. Данная статья представляет собой обзор современной литературы о ЛИ ФП, ассоциированной с приемом других групп ЛС и отдельных препаратов, не вошедших в вышеперечисленные группы. Анализ имеющейся литературы показал, что частота развития ЛИ ФП достигает 6,9% при приеме золедроновой кислоты и 1,5% – при приеме алендроната, хотя данные разных авторов в отношении причинно‑следственной связи между терапией бисфосфонатами и развитием ФП неоднозначны. Использование высоких доз глюкокортикостероидов (в суточной дозе ≥ 7,5 мг в пересчете на преднизолон) также ассоциировано с повышенным риском развития ФП (ОШ = 6,07; 95% ДИ: 3,90–9,42). Лечение нестероидными противовоспалительными средствами также взаимосвязано с более высоким риском развития ЛИ ФП по сравнению с лицами, не принимающими таковые,– коэффициент заболеваемости 1,17 (95% ДИ: 1,10–1,24) для неселективных и 1,27 (95% ДИ: 1,20–1,34) для ингибиторов циклооксигеназы‑2. В литературе имеются описание клинических случаев возникновения ЛИ ФП на фоне приема иммунодепрессантов (азатиоприн, метотрексат + этанерцепт, финголимод, циклоспорин); ЛС, влияющих на мочеполовую систему (варденафил, силденафил, йохимбина гидрохлорид, гексопреналин); местного анестетика бупивакаина, анаболических стероидов (тестостерона энантат, станозолол, ципионат тестостерон, нандролона деканоат, экстраболин) и никотин‑содержащего средства (никотин‑содержащая жевательная резинка).

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