Антикоагулянтная профилактика у пациентов с болезнями печени и фибрилляцией предсердий

Фибрилляция предсердий (ФП) является наиболее распространённой сердечной аритмией у взрослых во всём мире. Применение пероральных антикоагулянтов (ПОАК) – эффективный способ профилактики ишемического инсульта у пациентов с ФП, снижающий риск его возникновения примерно на 64 %. У пациентов с циррозом печени (ЦП) наличие ФП связано с более высокими показателями госпитальной летальности, инсульта и острого повреждения почек в сравнении с пациентами, не имеющими аритмии. Заболевания печени и особенно ЦП связаны с повышенным риском не только тромбоза, но и кровотечения, что делает решение об антикоагулянтной терапии у этих пациентов очень сложным. В статье рассматривается современная литература, касающаяся назначения современных ПОАК и традиционных антитромботических средств, таких как антагонисты витамина К и гепарины, у пациентов с циррозом печени и ФП.

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