Khaniukov O. O., Yehudina Ye. D., Sapozhnychenko L. V., Kalashnykova O. S., Bubliy R. V.

CLINICAL AND EXPERIMENTAL MEDICINE

Scentific article

The relevance of the atrial fibrillation (AF) problem is resulted from the significant prevalence of this arrhythmia, and also is associated with a fivefold increase in the developing of cardioembolic stroke risk. The appearance of new oral anticoagulants, in particular, dabigatran etaxilate, requires further research that will allow the effective and safe use of the direct inhibitor of thrombin – dabigatran etexilate in preventing thromboembolic complications (TEC) in patients with AF. Objective: to evaluate the efficacy and safety of dabigatran administration in patients with non-valvular AF, atrial appendage thrombosis and high hemorrhagic risk. Results. The study included 70 patients with non-valvular AF and atrial appendages thrombosis received anticoagulant therapy in oral dose of dabigatran 150 mg or 110 mg twice daily, depending on the glomerular filtration rate and the risk of bleeding. The average age of patients was 64 ± 9 years, the number of males – 40, females – 30. Number of patients with persistent AF were 65, with permanent – 5. The total experience of AF was about 6 months (0,5 ± 0,07 years). The main disease in 23 patients was coronary artery disease (stable angina pectoris II-III functional class), of which 9 patients had coronary artery disease in combination with arterial hypertension (AH). AH is diagnosed in 56 patients. Chronic heart failure (CHF) II function class (FC) according to NYHA classification was found in 53 patients, III FC – in 17 patients. According to the EHRA classification I FC was established in 5 patients with AF, II FC – in 53 patients, III FC – in 12 patients. At examination, diabetes mellitus was found in 9 (13.3%) patients. The renal and / or hepatic dysfunction is found in 6 (8.6%). An acute impairment of cerebral circulation in anamnesis was observed in 5 (7.2%) patients, of which 1 patient has this violation for the second time. It was found that patients with AF with non-valvular origin and atrial appendages thrombosis had an average of 3.6 points on CHA2DS2-VASc scale and 25.7% of them were referred to the high-risk group on the HAS-BLED scale. Patients with non-valvular AF necessarily need to be carried out through esophageal echocardiography with visualization of the atrium appendages in 4 weeks after receiving dabigatran in order to detect thrombosis. Conclusion. The use of dabigatran 150 mg or 110 mg twice daily is effective and safe in the prevention of TEC in patients with non-valvular origin AF, atrial appendage thrombosis and high risk of hemorrhagic complications.

atrial fibrillation, thromboembolic complications, dabigatran

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«Bulletin of problems biology and medicine» Issue 1 Part 1 (148), 2019 year, 193-199 pages, index UDK 616.125 – 008.313 – 005.6 – 036.3 – 085: 615.273

10.29254/2077-4214-2019-1-1-148-193-199