cardioКардиологияKardiologiia0022-90402412-5660Kardiomag10.18087/cardio.2021.12.n1872cardio-1872Research ArticleОБЗОРЫREVIEWSТактика ведения пациентов с фибрилляцией предсердий и малыми кровотечениями в условиях терапии прямыми пероральными антикоагулянтамиManagement of patients with atrial fibrillation and minor bleeding during therapy with direct oral anti-coagulantshttps://orcid.org/0000-0002-3014-6129БеленковЮ. Н.BelenkovYu. N.

Директор Клиники госпитальной терапии им. А.А. Остроумова, заведующий кафедрой госпитальной терапии №1  Института клинической медицины им. Н.В. Склифосовского, член-корр. РАН, академик РАМН, проф., д.м.н.

Director of the Clinic of Hospital Therapy named after A.A. Ostroumova, Head of the Department of Hospital Therapy No. 1 of the Institute of Clinical Medicine named after N.V. Sklifosovsky, Corresponding Member RAS, academician of RAMS, prof., DM

ynbelenkov@gmail.comhttps://orcid.org/0000-0002-3496-6466ПоповаЛ. В.PopovaL. V.

Associate Professor of the Department of Hospital Therapy No. 1 of the Institute of Clinical Medicine. N.V. Sklifosovsky, PhD, SPIN 1251-9273

mila_foka@mail.ruhttps://orcid.org/0000-0001-6817-6270ИльгисонисИ. С.IlgisonisS. I.

Профессор кафедры госпитальной терапии №1 Института клинической медицины им. Н.В. Склифосовского, к.м.н., врач-кардиолог, SPIN 6806-9299

Professor of the Department of Hospital Therapy No. 1 of the Institute of Clinical Medicine named after N.V. Sklifosovsky, MD, PhD, cardiologist

ichekneva@yandex.ruФГАОУ ВО Первый Московский государственный медицинский университет имени И.М. Сеченова Минздрава России (Сеченовский Университет), МоскваРоссияI.M. Sechenov First Moscow State Medical University, MoscowRussian Federation20213112202161127281Copyright © Kardiomag, 20212021KardiomagKardiomaghttps://cardio.elpub.ru/jour/about/submissions#copyrightNoticehttps://cardio.elpub.ru/jour/article/view/1872

Рекомендованной тактикой профилактики тромбоэмболических осложнений при фибрилляции предсердий (ФП) является использование пероральных антикоагулянтов (ПОАК). Препаратами выбора для предотвращения инсульта у подавляющего большинства пациентов с ФП, за исключением некоторых клапанных пороков, служат прямые пероральные антикоагулянты (ППОАК). Вне зависимости от класса препарата все антикоагулянты, даже при использовании правильной дозы, увеличивают риск развития кровотечений. Однако наличие малых кровотечений не служит абсолютным показанием к отмене ППОАК. В обзоре представлена тактика ведения пациентов при малых кровотечениях на фоне приема ППОАК.

The recommended tactics for prevention of thromboembolic complications of atrial fibrillation (AF) is the oral anticoagulant (OAC) treatment. The drugs of choice for preventing stroke for most patients with AF, excluding some valvular defects, are direct OACs (DOACS). Regardless of the drug class, all anticoagulants, even at appropriate doses, increase the risk of bleeding. However, the development of minor bleedings is not an absolute indication for DOAC withdrawal. This review presents a tactics for management of patients with minor bleeding associated with the DOAC treatment.

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