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Кардиоваскулярная терапия и профилактика

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ПРОБЛЕМЫ ВЫБОРА АНТИТРОМБОТИЧЕСКОЙ ТЕРАПИИ У БОЛЬНЫХ С НЕКЛАПАННОЙ ФИБРИЛЛЯЦИЕЙ ПРЕДСЕРДИЙ И КОМОРБИДНОЙ ПАТОЛОГИЕЙ

https://doi.org/10.15829/1728-8800-2015-4-75-85

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Аннотация

Как показывает клиническая практика, врач часто сталкивается с про­блемой непереносимости любых пероральных антикоагулянтов, как антагонистов витамина К, так и новых пероральных антикоагулянтов, или отказа пациентов от их применения. Поэтому перед врачом встает вопрос выбора антитромботической терапии у больных с фибрилля­цией предсердий (ФП), и, прежде всего, на фоне ишемической болез­ни сердца, сахарного диабета, перенесенного ишемического инсуль­та. В литературе остро обсуждается проблема целесообразности назначения таким больным аспирина в виде монотерапии с целью профилактики инсульта и инфаркта миокарда. В статье представлен клинический пример больной с неклапанной ФП, перенесшей ишеми- ческий инсульт, острый коронарный синдром на фоне множественной коморбидной патологии, показаны ошибки в тактике ведения больной в выборе антитромботической терапии и даны варианты решения проблемы вторичной профилактики тромбоэмболических осложне­ний, повторных ишемических событий с научно-обоснованной аргу­ментацией в соответствии с Международными и Российскими реко­мендациями.

 

Об авторах

Н. А. Козиолова
ГБОУ ВПО "Пермский государственный медицинский университет имени академика Е. А. Вагнера" Минздрава России. Пермь, Россия
Россия
д. м.н., профессор, зав. кафедрой пропедевтики внутренних болезней №2


Е. А. Полянская
ГБОУ ВПО "Пермский государственный медицинский университет имени академика Е. А. Вагнера" Минздрава России. Пермь, Россия
Россия
к. м.н., доцент кафедры


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Для цитирования:


Козиолова Н.А., Полянская Е.А. ПРОБЛЕМЫ ВЫБОРА АНТИТРОМБОТИЧЕСКОЙ ТЕРАПИИ У БОЛЬНЫХ С НЕКЛАПАННОЙ ФИБРИЛЛЯЦИЕЙ ПРЕДСЕРДИЙ И КОМОРБИДНОЙ ПАТОЛОГИЕЙ. Кардиоваскулярная терапия и профилактика. 2015;14(4):75-85. https://doi.org/10.15829/1728-8800-2015-4-75-85

For citation:


Koziolova N.A., Polyanskaya Е.А. THE SELECTION PROBLEMS OF ANTITHROMBOTIC THERAPY IN NONVALVULAR ATRIAL FIBRILLATION WITH COMORBIDITIES. Cardiovascular Therapy and Prevention. 2015;14(4):75-85. (In Russ.) https://doi.org/10.15829/1728-8800-2015-4-75-85

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ISSN 1728-8800 (Print)
ISSN 2619-0125 (Online)