Dabigatran in the prevention of stroke in nonvalvular atrial fibrillation: Complex clinical situations and real clinical practice


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Abstract

It is well known that there is a 5-fold increase in the incidence of strokes and systemic thromboembolic events in atrial fibrillation (AF) and anticoagulant therapy considerably reduces the risk of their development. Until recently, warfarin has been mainly used for this purpose. Dabigatran is the first representative of new-generation oral anticoagulants from a class of direct thrombin inhibitors to treat nonvalvular AF. Unlike warfarin, the drug provides a predictable and steady-state anticoagulant effect. This review presents the main pharmacological characteristics of dabigatran, the possibilities of its use in complex clinical situations in patients with AF in cardioversion, ablation, surgical/invasive interventions, hemorrhage, myocardial infarction, and stroke, as well as data on the use of the drug in real clinical practice.

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Дабигатран в профилактике инсульта при неклапанной фибрилляции предсердий: сложные клинические ситуации в реальной практике. - Аннотация. Хорошо известно, что частота развития инсультов и системных тромбоэмболических осложнений при фибрилляции предсердий (ФП) увеличивается в 5 раз, а антикоагулянтная терапия значительно снижает риск их развития. До недавнего времени с этой целью применялся в основном варфарин. Дабигатран - первый представитель пероральных антикоагулянтов нового поколения при неклапанной ФП из класса прямых ингибиторов тромбина. В отличие от варфарина он обеспечивает прогнозируемый и постоянный антикоагулянтный эффект. Его основные фармакологические характеристики, возможности применения в сложных клинических ситуациях у пациентов с ФП при кардиоверсии, аблации, хирургических/инвазивных вмешательствах, кровотечении, инфаркте миокарда и инсульте, а также данные об использовании препарата в реальной клинической практике представлены в предлагаемом обзоре.
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