Patient with myocardial infarction, atrial fibrillation and high risk for hemorrhage: reasonable choice of anticoagulant for effective prevention of ischemic events
https://doi.org/10.17802/2306-1278-2018-7-4S-135-145
Abstract
Current clinical practice faces the challenges in selecting optimal drugs and the duration of antithrombotic treatment in patients with acute coronary syndrome with atrial fibrillation. A continuous increase of using non-vitamin K oral anticoagulants (NOAC), dabigatran, rivaroxaban, apixaban, edoxaban, and novel antiplatelet agents, prasugrel and ticagrelor, has complicated the decision-making process in this group of patients. The presented clinical case reports the use of dabigatran as a part of double antithrombotic therapy in an elderly patient with type 2 myocardial infarction, paroxysmal AF and a high risk for hemorrhage. The drug choice and its dosage were chosen using the personalized risk assessment. The presented approach has been early proved by the results of the recent randomized clinical trials and, therefore, may be translated into routine clinical practice.
About the Authors
T. B. Pecherina
Federal State Budgetary Scientific Institution Research Institute for Complex Issues of Cardiovascular Diseases; State Budgetary Healthcare Institution of the Kemerovo Region Kemerovo Regional Clinical Cardiology Dispensary named after academician L.S. Barbarash
Russian Federation
Competing Interests: Нет конфликта интересов
Russian Federation
Pecherina Tamara B. - PhD, senior researcher at the Laboratory of Pathophysiology of Multivessel Coronary Artery Disease and Polyvascular Disease RICCD, cardiologist at the Emergency Department, KSMU.
6, Sosnoviy blvd, Kemerovo, 650002, tel. +79059197979
Competing Interests: Нет конфликта интересов
V. O. Zlydneva
Federal State Budgetary Scientific Institution Research Institute for Complex Issues of Cardiovascular Diseases
Russian Federation
Competing Interests: Нет конфликта интересов
Russian Federation
Zlydneva Valeriya O. - cardiology fellow at KSMU.
6, Sosnoviy blvd, Kemerovo, 650002
Competing Interests: Нет конфликта интересов
V. V. Kashtalap
Federal State Budgetary Scientific Institution Research Institute for Complex Issues of Cardiovascular Diseases; State Budgetary Educational Institution of Higher Education “Kemerovo State Medical University” of the Ministry of Healthcare of the Russian Federation
Russian Federation
Competing Interests: Нет конфликта интересов
Russian Federation
Kashtalap Vasily V. - MD, PhD, Head of Laboratory of Pathophysiology of Multivessel Coronary Artery Disease and Polyvascular Disease RICCD, Associate Professor at the Department of Cardiology and Cardiovascular Surgery, KSMU.
6, Sosnoviy blvd, Kemerovo, 650002; 22a, Voroshilova St., Kemerovo, 650056
Competing Interests: Нет конфликта интересов
O. L. Barbarash
Federal State Budgetary Scientific Institution Research Institute for Complex Issues of Cardiovascular Diseases; State Budgetary Educational Institution of Higher Education “Kemerovo State Medical University” of the Ministry of Healthcare of the Russian Federation
Russian Federation
Competing Interests: Нет конфликта интересов
Russian Federation
Barbarash OlgaL. - PhD, Professor, Corresponding member of the Russian Academy of Sciences, Director RICCD, Head of the Department of Cardiology and Cardiovascular Surgery, KSMU.
6, Sosnoviy blvd, Kemerovo, 650002; 22a, Voroshilova St., Kemerovo, 650056
Competing Interests: Нет конфликта интересов
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Review
For citations:
Pecherina T.B., Zlydneva V.O., Kashtalap V.V., Barbarash O.L. Patient with myocardial infarction, atrial fibrillation and high risk for hemorrhage: reasonable choice of anticoagulant for effective prevention of ischemic events. Complex Issues of Cardiovascular Diseases. 2018;7(4S):135-145. (In Russ.) https://doi.org/10.17802/2306-1278-2018-7-4S-135-145
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