Рекомендации по применению прямых пероральных антикоагулянтов у пациентов с фибрилляцией предсердий (по материалам Европейской Ассоциации по изучению ритма сердца, 2018 г.)

Прямые пероральные антикоагулянты (ППОАК) все более широко применяются в клинической практике. Остается много нерешенных вопросов о том, как оптимально использовать ППОАК в конкретной клинической ситуации. Европейская ассоциация по изучению ритма сердца в апреле2018 г. представила обновленные рекомендации по применению ППОАК у пациентов с фибрилляцией предсердий. Группа авторов рассмотрели ряд конкретных клинических вариантов, для которых были сформулированы практические советы на основе имеющихся доказательств, полученных в рандомизированных клинических исследованиях (РКИ); определены показания к применению ППОАК; практическая старт-программа и последующая схема ведения пациентов, принимающих ППОАК; рассматриваются фармакокинетика и лекарственное взаимодействие ППОАК; возможность применения их у пациентов с хронической почечной недостаточностью или прогрессирующим заболеванием печени и многие другие вопросы.    

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