COMBINED ANTITHROMBOTIC THERAPY IN CASE OF PLANNED PERCUTANEOUS CORONARY INTERVENTIONS IN PATIENTS WITH ATRIAL FIBRILLATION IN ACTUAL CLINICAL PRACTICE
N.Yu. Khorkova, A.Yu. Rychkov, A.V. Belokurova
Tyumen Cardiology Research Center, Tomsk National Research Medical Center of RAS, 625026, Tyumen, Melnikayte str., 111
Keywords: фибрилляция предсердий, чрескожное коронарное вмешательство, антитромботическая терапия, atrial fibrillation, percutaneous coronary intervention, antithrombotic therapy
Abstract
Retrospective analysis enrolled 124 patients (90 males and 34 females, mean age 67.2 ± 7.4 years) with stable coronary artery disease (CAD) and non-valvular atrial fibrillation (AF) who underwent inpatient treatment in 2016 and 2017. All patients had planned percutaneous coronary intervention (PCI) performed. As a part of combined antithrombotic therapy 104 patients received peroral anticoagulants after planned PCI. It was demonstrated that the majority of AF patients after planned PCI got triple or double antithrombotic therapy including oral anticoagulants in actual clinical practice. Significant decrease of using antiaggregants combination only in patients of this category was stated. According to clinical observation a patient with high risk of thromboembolic complications, hemorrhage, macrohematuria and planned surgical intervention due to comorbidity after PCI received double antithrombotic therapy including clopidogrel and dabigatran 110 mg twice per 24 hours. No thrombotic complications of coronary atherosclerosis, cardioembolic complications, clinically relevant bleeding were noticed in long-term postsurgical period. Modern evidential basis of advantages of double antithrombotic therapy with direct oral anticoagulants was presented. It is crucially important for patients with high risk of hemorrhagic complications.
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