Антикоагулянтная терапия у пожилых пациентов: дилемма выбора между эффективностью и безопасностью
Аннотация
В статье обсуждаются вопросы эффективности и безопасности применения пероральных антикоагулянтов у пожилых пациентов с неклапанной фибрилляцией предсердий. Приводятся результаты рандомизированных контролируемых исследований RE-LY, ROCKET-AF, ARISTOTLE и ENGAGE AFTIMI 48, включая анализ подгрупп у лиц в возрасте от 75 лет, у пациентов с нарушением функции почек и высоким риском желудочно-кишечных кровотечений;даются рекомендации по оптимальному выбору перорального антикоагулянта у данных категорий пациентов. Также рассматриваются основные положения консенсусного документа FORTA, целью которого является индивидуализация лечения пожилых пациентов на основании клинических характеристик больного с учетом возможных ошибок при использовании лекарственных средств. Междисциплинарный совет экспертов FORTA считает апиксабан наиболее безопасным антикоагулянтом у пожилых пациентов.
Ключевые слова
Об авторах
Н. М. Воробьева
ФГБОУ ВО «Российский национальный исследовательский медицинский университет имени Н. И. Пирогова» Минздрава России
Россия
Россия
О. Н. Ткачева
ФГБОУ ВО «Российский национальный исследовательский медицинский университет имени Н. И. Пирогова» Минздрава России
Россия
Россия
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Рецензия
Для цитирования:
Воробьева Н.М., Ткачева О.Н. Антикоагулянтная терапия у пожилых пациентов: дилемма выбора между эффективностью и безопасностью. Медицинский алфавит. 2018;2(16):6-14.
For citation:
Vorobyeva N.M., Tkachyova O.N. Anticoagulant therapy in elderly patients: dilemma of choice between efficacy and safety. Medical alphabet. 2018;2(16):6-14. (In Russ.)
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