avkАрхивъ внутренней медициныThe Russian Archives of Internal Medicine2226-67042411-6564“SINAPS” LLC10.20514/2226-6704-2013-0-2-57-64avk-357Research ArticleБОЛЕЗНИ СЕРДЦА И СОСУДОВПРИМЕНЕНИЕ ПЕРОРАЛЬНЫХ АНТИКОАГУЛЯНТОВ ПРИ ФИБРИЛЛЯЦИИ ПРЕДСЕРДИЙ: СОВРЕМЕННОЕ СОСТОЯНИЕ ПРОБЛЕМЫ И НОВЫЕ ВОЗМОЖНОСТИПРИМЕНЕНИЕ ПЕРОРАЛЬНЫХ АНТИКОАГУЛЯНТОВ ПРИ ФИБРИЛЛЯЦИИ ПРЕДСЕРДИЙ: СОВРЕМЕННОЕ СОСТОЯНИЕ ПРОБЛЕМЫ И НОВЫЕ ВОЗМОЖНОСТИСторожаковГ. И.СторожаковГ. И.

кафедра госпитальной терапии No 2 на базе ГКБ No 12, г. Москва

кафедра госпитальной терапии No 2 на базе ГКБ No 12, г. Москва

БорисовС. Н.БорисовС. Н.

кафедра госпитальной терапии No 2 на базе ГКБ No 12, г. Москва

кафедра госпитальной терапии No 2 на базе ГКБ No 12, г. Москва

rgmugt2@mail.ruГендлинГ. Е.ГендлинГ. Е.

кафедра госпитальной терапии No 2 на базе ГКБ No 12, г. Москва

кафедра госпитальной терапии No 2 на базе ГКБ No 12, г. Москва

МелеховА. В.МелеховА. В.

кафедра госпитальной терапии No 2 на базе ГКБ No 12, г. Москва

кафедра госпитальной терапии No 2 на базе ГКБ No 12, г. Москва

ГБОУ ВПО «Российский национальный исследовательский медицинский университет им. Н.И. Пирогова»РоссияГБОУ ВПО «Российский национальный исследовательский медицинский университет им. Н.И. Пирогова»Russian Federation201328042013025764Copyright © Сторожаков Г.И., Борисов С.Н., Гендлин Г.Е., Мелехов А.В., 20132013Сторожаков Г.И., Борисов С.Н., Гендлин Г.Е., Мелехов А.В.Сторожаков Г.И., Борисов С.Н., Гендлин Г.Е., Мелехов А.В.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.medarhive.ru/jour/article/view/357

Отечественный и зарубежный опыт профилактики тромбоэмболических осложнений фибрилляции предсердий на современном этапе показывают, что наиболее распространённая стратегия профилактики инсульта с использованием варфарина как в России, так и за рубежом далека от желаемой. Предлагаемые меры по её усовершенствованию (знание врачами особенностей фармакодинамики, фармакокинетики и фармакогенетики препарата, регулярный контроль МНО) далеко не всегда могут реализовываться в клинической практике. Важной задачей становится внедрение новых антикоагулянтов, не уступающих по эффективности варфарину, но более удобных в применении, таких как ривароксабан (Ксарелто). Авторы считают, что сравнимая с варфарином безопасность при не уступающей/превосходящей эффективности, удобство дозирования, отсутствие необходимости лабораторного контроля на фоне терапии, отсутствие неблагоприятных взаимодействий с лекарствами и пищевыми продуктами в ближайшее время позволят ривароксабану существенно повысить приверженность врачей и пациентов антикоагулянтной терапии. 

Contemporary Russian and international experience of prophylaxis of thromboembolic complications of atrial fibrillation indicates that the most popular strategy for the prevention of stroke with warfarin is far from optimum. Measures proposed to improve it (physicians’ knowledge of pharmacodynamics features, pharmacokinetics and pharmacogenetics of the drug, regular monitoring of International Normalized Ratio) can not always be implemented in clinical practice. Introduction of new anticoagulants, as effective as warfarin, but more convenient to use, is very important now. Such anticoagulant is rivaroxaban (Xarelto). Authors believe that comparable safety with warfarin and not inferior/superior safety, ease of dosing, no need for laboratory monitoring during therapy, no adverse interactions with medications and food products will allow rivaroxaban to increase significantly the compliance of doctors and patients to anticoagulant therapy in the near future. 

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The authors declare that there are no conflicts of interest present.