cardioКардиологияKardiologiia0022-90402412-5660Kardiomag10.18087/cardio.2021.3.n1511cardio-1511Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИRESEARCH ARTICLESЭффективность модуля принятия решений в персонализированном выборе антикоагулянтаEfficiency of the Decision-Making Module in the Personalized Choice of an Anticoagulanthttps://orcid.org/0000-0002-2327-2637ГорбуноваЕ. В.GorbunovaE. V.

доктор медицинских наук, ведущий научный сотрудник лаборатории нарушений ритма сердца и электрокардиостимуляции

PhD, leading researcher at the Laboratory of Cardiac Arrhythmias and Pacing

e.v.gorbunova@yandex.ruДувановаС. П.DuvanovaS. P.

клинический ординатор

a resident

duvasp@kemcardio.ruФилимоновК. М.FilimonovK. M.

аспирант

a resident

philimonovkm@mail.comhttps://orcid.org/0000-0002-8277-5584МамчурС. Е.MamchurS. E.

доктор медицинских наук, зав.лабораторией нарушений ритма сердца и электрокардиостимулчции

Head of the Laboratory of Cardiac Arrhythmias and Pacing

sergei_mamchur@mail.ruhttps://orcid.org/0000-0003-4649-2947МакаровС. А.MakarovS. A.

доктор медицинских наук, зав.лабораторией моделирования управленческих технологий

PhD, Head of the Laboratory for Modeling Medical Technologies

makarov@kemcardio.ruФГБНУ «НИИ комплексных проблем сердечно-сосудистых заболеваний», КемеровоРоссияResearch Institute for Complex Issues of Cardiovascular Diseases, KemerovoRussian Federation2021300320216131822Copyright © Kardiomag, 20212021KardiomagKardiomaghttps://cardio.elpub.ru/jour/about/submissions#copyrightNoticehttps://cardio.elpub.ru/jour/article/view/1511

Цель      Оценить эффективность модуля принятия решений в выборе перорального антикоагулянта у пациентов с фибрилляцией предсердий.

Материал и методы        Обследованы 638 больных с фибрилляцией предсердий в возрасте 68,2±4,5 года. Использовались шкалы CHA2DS2-VASc, HAS-BLED, 2MАСЕ, калькулятор клиренса креатинина и опросник Мориски–Грина.

Результаты       У 311 (48,75 %) пациентов регистрировалась пароксизмальная форма фибрилляции предсердий, персистирующая – у 138 (21,6 %), длительно персистирующая – у 44 (6,9 %), постоянная – у 145 (22,7 %) больных. Средняя оценка по шкале CHADS2‑VASc составила 4,82 балла, по шкале НAS-BLED – 2,9 балла и 2MACE – 2,28 балла, приверженность к лечению – 3,52 балла. Ривароксабан принимали 172 (26,9 %) пациента, апиксабан – 166 (26 %), дабигатран – 84 (13,2 %), варфарин – 210 (32,9 %), ацетилсалициловую кислоту – 6 (1 %).

Заключение         Разработанный модуль принятия решений основан на научном обосновании персонализированного выбора перорального антикоагулянта, способствует актуализации знаний по основным вопросам назначения.

 

Aim        To evaluate the effectiveness of the decision-making module in selecting an oral anticoagulant for patients with atrial fibrillation.

Material and methods        638 patients with atrial fibrillation aged 68.2±4.5 years were evaluated. The CHA2DS2-VASc, HAS-BLED, and 2MАСЕ scales, the creatinine clearance calculator, and the Morisky-Green questionnaire were used.

Results   311 (48.75 %) patients had paroxysmal atrial fibrillation, 138 (21.6%) had persistent atrial fibrillation, 44 (22.7%) had long-standing persistent atrial fibrillation, and 145 (22.7 %) had permanent atrial fibrillation. Mean CHADS2‑VASc scale score was 4.82; НAS-BLED scale score was 2.9; 2MACE score was 2.28; and compliance score was 3.52. 172 (26.9 %) patients were treated with rivaroxaban; 166 (26 %), with apixaban; 84 (13.2 %), with dabigatran; 210 (32.9 %), with warfarin; and 6 (1 %), with acetylsalicylic acid.

Conclusion            The developed decision-making module is based on scientific justification of personalized selection of the oral anticoagulant and updates the knowledge on major issues of prescription.

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