rpcardioRational Pharmacotherapy in CardiologyРациональная Фармакотерапия в Кардиологии1819-64462225-3653«SILICEA-POLIGRAF» LLC10.20996/1819-6446-2017-13-2-275-283rpcardio-1457Research ArticleCURRENT QUESTIONS OF CLINICAL PHARMACOLOGYАКТУАЛЬНЫЕ ВОПРОСЫ КЛИНИЧЕСКОЙ ФАРМАКОЛОГИИAPPROACHES TO ANTITHROMBOTIC THERAPY IN ELDERLY PATIENTS WITH ATRIAL FIBRILLATIONПОДХОДЫ К АНТИТРОМБОТИЧЕСКОЙ ТЕРАПИИ У ПАЦИЕНТОВ ПОЖИЛОГО ВОЗРАСТА C ФИБРИЛЛЯЦИЕЙ ПРЕДСЕРДИЙУшкаловаЕ. А.UshkalovaE. A.

Ушкалова Елена Андреевна – доктор медицинских наук, профессор кафедры общей и клинической фармакологии

 

Elena A. Ushkalova - MD, PhD, Professor, Chair of General and Clinical Pharmacology 

Miklukho-Maklaya ul. 6,Moscow, 117198 

eushk@yandex.ruЗыряновС. К.ZyryanovS. K.

Зырянов Сергей Кенсаринович – доктор медицинских наук, зав. кафедрой общей и клинической фармакологии

Sergei K. Zyryanov - MD, PhD, Professor, Head of Chair of General and Clinical Pharmacology 

Miklukho-Maklaya ul. 6,Moscow, 117198 

ДумченкоЕ. В.DumchenkoE. V.

Думченко Екатерина Владимировна — аспирант кафедры общей и клинической фармакологии

Ekaterina V. Dumchenko - MD, PhD Student, Chair of General and Clinical Pharmacology 

Miklukho-Maklaya ul. 6,Moscow, 117198 

Российский университет дружбы народовРоссияPeople's Friendship University of RussiaRussian Federation201705052017132275283Copyright © Ushkalova E.A., Zyryanov S.K., Dumchenko E.V., 20172017Ушкалова Е.А., Зырянов С.К., Думченко Е.В.Ushkalova E.A., Zyryanov S.K., Dumchenko E.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.rpcardio.online/jour/article/view/1457

Advanced age is the most important and independent risk factor for the development of atrial fibrillation (AF). The proportion of patients with AF at the age of 65-85 years reaches 70%, and average age of patients with AF is 75 years. Antithrombotic therapy of AF in the elderly is challenging for several reasons. On the one hand, elderly patients are at an increased risk of systemic embolism and stroke and fatal outcomes of stroke are higher in the elderly compared with these in the younger patients. On the other hand, elderlies are at an increased risk of bleeding. In addition, they have important comorbidities and are treated with drugs that can interact with antithrombotic agents. The article discusses tools used to assess risks of thromboembolic and hemorrhagic complications and general approaches to antithrombotic treatment of elderly patients.

Пожилой возраст – наиболее важный и независимый фактор риска развития фибрилляции предсердий (ФП). Доля больных с ФП в возрасте 65-85 лет достигает 70%, а средний возраст пациентов с ФП составляет 75 лет. Антитромботическая терапия у пожилых затруднена в силу ряда причин. С одной стороны, у пожилых повышен риск развития системной эмболии и инсульта, а также фатальных исходов инсульта по сравнению с более молодыми пациентами. С другой стороны, у пожилых пациентов повышен риск кровотечений. Кроме того, они страдают сопутствующими заболеваниями и получают препараты, которые могут вступать во взаимодействия с антитромботическими средствами. В статье обсуждаются шкалы, применяемые для оценки риска тромбоэмболических и геморрагических осложнений и общие подходы к антитромботической терапии у пожилых пациентов.

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The authors declare that there are no conflicts of interest present.