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ANALYSIS OF ANTITHROMBOTIC THERAPY IN IN-PATIENTS WITH PERMANENT ATRIAL FIBRILLATION (PHARMACOEPIDEMIOLOGY STUDY)

https://doi.org/10.20996/1819-6446-2014-10-2-174-178

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Abstract

Aim. To assess prescribing structure, efficacy and safety of antithrombotic therapy in in-patients with permanent atrial fibrillation (AF).

Material and methods. Simple non-comparative retrospective descriptive one stage pharmacoepidemiological study was performed on the basis of analysis of 263 case histories of patients with permanent AF admitted to cardiology department of a general hospital.

Results. All patients were stratified into three groups depending on the value of the index CHA2DS2-VASc. Antithrombotic therapy was evaluated in each group. 1% patients (n=3) had minimal stroke probability, so there was no need for antithrombotic therapy. 6% (n=15) patients with AF had 1 point according to CHA2DS2-VASc scale. Acetylsalicylic acid was prescribed to 0.7% of cases (n=2), warfarin – to 5% (n=12). High risk of thromboembolic complications (CHA2DS2-VASc≥2) was revealed in 93% patients (n=245), 65% (n=172) of them received warfarin.

Conclusions. Antithrombotic therapy was administered for the vast majority of patients with AF (97.7%). Antiplatelet drugs were used in 25.4% of cases, including for patients with high risk of thromboembolic complications. Warfarin was prescribed in 70.3%. However, target level of hypocoagulation has been achieved in 51% patients only.

About the Authors

V. I. Petrov
Volgograd State Medical University
Russian Federation


O. V. Shatalova
Volgograd State Medical University
Russian Federation


A. S. Maslakov
Volgograd State Medical University
Russian Federation


References

1. National Guidelines for Diagnosis and Treatment of Atrial Fibrillation, 2012. Available at: http://scardio.ru/content/Guidelines/FP_rkj_13.pdf. Accessed by 03/04/2014. Russian (Национальные рекомендации по диагностике и лечению фибрилляции предсердий, 2011. Доступно на: http://scardio.ru/content/Guidelines/FP_rkj_13.pdf. Проверено 03.04.2014).

2. Guidelines for the management of atrial fibrillation: the Task Force for the Management of Atrial Fibrillation of the European Society of Cardiology (ESC). Europace 2010;12(10):1360-420.

3. 2011 ACCF/AHA/HRS focused updates incorporated into the ACC/AHA/ESC 2006 Guidelines for the management of patients with atrial fibrillation. J Am Coll Cardiol 2011;57(11):e101-98.

4. Naccarelli GV, Varker H, Lin J, Schulman KL. Increasing prevalence of atrial fibrillation and flutter in the United States. Am J Cardiol 2009;104:1534-9.

5. Lip GY, Nieuwlaat R, Pisters R et al. Refining clinical risk stratification for predicting stroke and thromboembolism in atrial fibrillation using a novel risk factor based approach: the Euro Heart Survey on atrial fibrillation. Chest 2010;137:263-72.

6. Pirmohamed M. Warfarin: almost 60 years old and still causing problems. BrJ Clin Pharmacol 2006;62: 509-11.

7. Ageno W, Gallus AS, Wittkowsky A, Geerts MC et al. Oral Anticoagulant Therapy: Antithrombotic Therapy and Prevention of Thrombosis (9thed: ACCP Evidence-Based Clinical Practice Guidelines). Chest 2012;141;e44S-e88S.

8. Schwammenthal Y., Bornstein N., Schwammenthal E. et al. Relation of effective anticoagulation in patients with atrial fibrillation to stroke severity and survival (from the National Acute Stroke Israeli Survey [NASIS]). Am J Cardiol 2010;105(3):411-416.

9. Instructions for use PRADAKSA ©. Available at: http://grls.rosminzdrav.ru/InstrImgMZ.aspx?isNew=1&idReg=23553&page=2&isOld=1&t=f96c6075-9340-4fc5-bde7-25af25d30070. Accessed by04/03/2014.Russian (Инструкция по применению лекарственного препаратаПРАДАКСА©. Доступно на: http://grls.rosminzdrav.ru/InstrImgMZ.aspx?isNew=1&idReg=23553&page=2&isOld= 1&t=f96c6075-9340-4fc5-bde7-25af25d30070. Проверено 03.04.2014).

10. Instructions for use ofthe drug Xarelto ©.Available at: http://grls.rosminzdrav.ru/InstrImgMZ.aspx?isNew=1&idReg=27480&page=2&isOld=1&t=4cdc9200-b107-4569-974c-0dc40d1b86a8. Accessed by 04/03/2014. Russian (Инструкция по применению лекарственного препарата КСАРЕЛТО©.Доступно на: http://grls.rosminzdrav.ru/InstrImgMZ.aspx?isNew=1&idReg=27480&page= 2&isOld=1&t=4cdc9200-b107-4569-974c-0dc40d1b86a8. Проверено 03.04.2014).

11. Petrov V. I. Applied pharmacoepidemiology. Moscow: GJEOTAR-Media; 2008). Russian Петров В. И. Прикладная фармакоэпидемиология. М.: ГЭОТАР-Медиа; 2008).

12. Shatalova O.V., Smuseva O.N., MaslakovA.S.Antithrombotic therapy safety monitoring based on spontaneous reports. Ration Pharmacother Cardiol 2013;9(2):123-126. Russian (Шаталова О.В., Смусева О.Н.,МаслаковА.С.Мониторинг безопасности антитромботической терапии методом спонтанных сообщений. Рациональная Фармакотерапия в Кардиологии 2013;9(2):123-126).

13. Graifer I.V., Reshet'ko O.V., Furman N.V. Pharmacoepidemiological analysis of the treatment of paroxysmal and persistent atrial fibrillation in every day clinical practice. Ration Pharmacother Cardiol 2011;7(2):177-184. Russian (Грайфер И.В., Решетько О.В., Фурман Н.В. Фармакоэпидемиологическийанализлеченияпароксизмальнойиперсистирущейфибрилляциипредсердийвреальной клинической практике. Рациональная Фармакотерапия В Кардиологии 2011;7(2):177-184).

14. Gavrisyuk EV, Ignatiev IV, Sychev DA, et al. Analysis of the application of indirect anticoagulant warfarin in patientswith persistent atrialfibrillation in outpatient conditions. Clinical Pharmacology and Therapy 2012; (1): 42-6. Russian (Гаврисюк Е.В., Игнатьев И.В., Сычев Д.А., и др. Анализ применения непрямого антикоагулянта варфарина у пациентов с постояннойформойфибрилляции предсердий в поликлинических условиях. Клиническая Фармакология и Терапия 2012;(1):42-6).

15. Sychev DA. Personalised anticoagulant therapy based on the results of pharacogenetic test (guidelines). S.Petersburg:ALKOR BIO: 2010. Russian (СычёвД.А.Персонализированная антикоагулянтная терапия на основе результатов фармакогенетического тестирования. Методические рекомендации. СПб.: АЛКОР БИО: 2010.)


For citation:


Petrov V.I., Shatalova O.V., Maslakov A.S. ANALYSIS OF ANTITHROMBOTIC THERAPY IN IN-PATIENTS WITH PERMANENT ATRIAL FIBRILLATION (PHARMACOEPIDEMIOLOGY STUDY). Rational Pharmacotherapy in Cardiology. 2014;10(2):174-178. (In Russ.) https://doi.org/10.20996/1819-6446-2014-10-2-174-178

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ISSN 1819-6446 (Print)
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