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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="en"><front><journal-meta><journal-id journal-id-type="publisher-id">rpcardio</journal-id><journal-title-group><journal-title xml:lang="en">Rational Pharmacotherapy in Cardiology</journal-title><trans-title-group xml:lang="ru"><trans-title>Рациональная Фармакотерапия в Кардиологии</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">1819-6446</issn><issn pub-type="epub">2225-3653</issn><publisher><publisher-name>«SILICEA-POLIGRAF» LLC</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.20996/1819-6446-2011-7-1-75-81</article-id><article-id custom-type="elpub" pub-id-type="custom">rpcardio-703</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>CURRENT QUESTIONS OF CLINICAL PHARMACOLOGY</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>АКТУАЛЬНЫЕ  ВОПРОСЫ  КЛИНИЧЕСКОЙ ФАРМАКОЛОГИИ</subject></subj-group></article-categories><title-group><article-title>ANTITHROMBOTIC THERAPY IN ATRIAL FIBRILLATION: NEW DATA AND NEW HORIZONS</article-title><trans-title-group xml:lang="ru"><trans-title>АНТИТРОМБОТИЧЕСКАЯ ТЕРАПИЯ ПРИ ФИБРИЛЛЯЦИИ ПРЕДСЕРДИЙ: НОВЫЕ ДАННЫЕ И НОВЫЕ ГОРИЗОНТЫ</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Гиляров</surname><given-names>М. Ю.</given-names></name><name name-style="western" xml:lang="en"><surname>Gilyarov</surname><given-names>M. Yu.</given-names></name></name-alternatives><bio xml:lang="ru"><p>к.м.н., доцент кафедры профилактической и неотложной кардиологии факультета последипломного профессионального образования</p></bio><email xlink:type="simple">gilarov@rambler.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Сулимов</surname><given-names>В. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Sulimov</surname><given-names>V. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>д.м.н., профессор, заведующий кафедрой факультетской терапии №1 лечебного факультета</p></bio><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>Первый Московский медицинский университет им. И.М.Сеченова</institution><country>Россия</country></aff><aff xml:lang="en"><institution>I.M. Setchenov First Moscow State Medical University</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2011</year></pub-date><pub-date pub-type="epub"><day>10</day><month>01</month><year>2016</year></pub-date><volume>7</volume><issue>1</issue><fpage>75</fpage><lpage>81</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Gilyarov M.Y., Sulimov V.A., 2016</copyright-statement><copyright-year>2016</copyright-year><copyright-holder xml:lang="ru">Гиляров М.Ю., Сулимов В.А.</copyright-holder><copyright-holder xml:lang="en">Gilyarov M.Y., Sulimov V.A.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.rpcardio.online/jour/article/view/703">https://www.rpcardio.online/jour/article/view/703</self-uri><abstract><p>New data and perspectives of antithrombotic therapy are highlighted in patients with atrial fibrillation. Factors of warfarin therapy efficacy, as well as the possibility of new antithrombotic drugs are considered. Special attention are paid to the direct thrombin inhibitors — dabigatran. Possibilities and usage prospects of dabigatran in patients with atrial fibrillation are discussed in detail in the light of new results of RE-LY trial.</p></abstract><trans-abstract xml:lang="ru"><p>Освещены новые данные и перспективы антитромботической терапии у пациентов с фибрилляцией предсердий. Рассмотрены факторы эффективности терапии варфарином, а также возможности применения новых антитромботических препаратов. Особое внимание уделено прямому ингибитору тромбина — дабигатрану. Детально обсуждены возможности и перспективы его применения у пациентов с фибрилляцией предсердий в свете представленных результатов исследования RE-LY.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>фибрилляция предсердий</kwd><kwd>антикоагулянтная терапия</kwd><kwd>варфарин</kwd><kwd>дабигатран</kwd></kwd-group><kwd-group xml:lang="en"><kwd>atrial fibrillation</kwd><kwd>anticoagulation</kwd><kwd>warfarin</kwd><kwd>dabigatran</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Hart R.G., Pearce, L.A., Rothbart, R.M. et al. Stroke with intermittent atrial fibrillation: incidence and predictors during aspirin therapy. JACC 2000; 35(1): 183-187.</mixed-citation><mixed-citation xml:lang="en">Hart R.G., Pearce, L.A., Rothbart, R.M. et al. Stroke with intermittent atrial fibrillation: incidence and predictors during aspirin therapy. JACC 2000; 35(1): 183-187.</mixed-citation></citation-alternatives></ref><ref id="cit2"><label>2</label><citation-alternatives><mixed-citation xml:lang="ru">Hart R.G., Pearce, L.A., Koudstaal, P.J. Transient Ischemic Attacks in Patients With Atrial Fibrillation: Implications for Secondary Prevention: The European Atrial Fibrillation Trial and Stroke Prevention in Atrial Fibrillation III Trial. Stroke 2004; 35(4): 948 - 951.</mixed-citation><mixed-citation xml:lang="en">Hart R.G., Pearce, L.A., Koudstaal, P.J. Transient Ischemic Attacks in Patients With Atrial Fibrillation: Implications for Secondary Prevention: The European Atrial Fibrillation Trial and Stroke Prevention in Atrial Fibrillation III Trial. Stroke 2004; 35(4): 948 - 951.</mixed-citation></citation-alternatives></ref><ref id="cit3"><label>3</label><citation-alternatives><mixed-citation xml:lang="ru">Hohnloser S.H., Pajitnev D., Pogue, J. at al. Incidence of Stroke in Paroxysmal Versus Sustained Atrial Fibrillation in Patients Taking Oral Anticoagulation or Combined Antiplatelet Therapy: An ACTIVE W Sub-study. JACC 2007; 50(22): 2156 - 2161.</mixed-citation><mixed-citation xml:lang="en">Hohnloser S.H., Pajitnev D., Pogue, J. at al. Incidence of Stroke in Paroxysmal Versus Sustained Atrial Fibrillation in Patients Taking Oral Anticoagulation or Combined Antiplatelet Therapy: An ACTIVE W Sub-study. JACC 2007; 50(22): 2156 - 2161.</mixed-citation></citation-alternatives></ref><ref id="cit4"><label>4</label><citation-alternatives><mixed-citation xml:lang="ru">Kannel W.B., Abbott, R.D., Savage D.D., McNamara P.M. Coronary heart disease and atrial fibrillation: the Framingham Study. Am Heart J 1983; 106(2): 389 - 396.</mixed-citation><mixed-citation xml:lang="en">Kannel W.B., Abbott, R.D., Savage D.D., McNamara P.M. Coronary heart disease and atrial fibrillation: the Framingham Study. Am Heart J 1983; 106(2): 389 - 396.</mixed-citation></citation-alternatives></ref><ref id="cit5"><label>5</label><citation-alternatives><mixed-citation xml:lang="ru">Nieuwlaat R., Dinh, T., Olsson S.B. et al. Should we abandon the common practice of withholding oral anticoagulation in paroxysmal atrial fibrillation? Eur Heart J 2008; 29(7): 915 - 922.</mixed-citation><mixed-citation xml:lang="en">Nieuwlaat R., Dinh, T., Olsson S.B. et al. Should we abandon the common practice of withholding oral anticoagulation in paroxysmal atrial fibrillation? Eur Heart J 2008; 29(7): 915 - 922.</mixed-citation></citation-alternatives></ref><ref id="cit6"><label>6</label><citation-alternatives><mixed-citation xml:lang="ru">Hart R.G., Pearce, L.A., Aguilar M.I. Meta-analysis: Antithrombotic Therapy to Prevent Stroke in Patients Who Have Nonvalvular Atrial Fibrillation. Ann Intern Med 2007; 146(12): 857 - 867.</mixed-citation><mixed-citation xml:lang="en">Hart R.G., Pearce, L.A., Aguilar M.I. Meta-analysis: Antithrombotic Therapy to Prevent Stroke in Patients Who Have Nonvalvular Atrial Fibrillation. Ann Intern Med 2007; 146(12): 857 - 867.</mixed-citation></citation-alternatives></ref><ref id="cit7"><label>7</label><citation-alternatives><mixed-citation xml:lang="ru">The ACTIVE Writing Group. Clopidogrel plus aspirin versus oral anticoagulation for atrial fibrillation in the Atrial fibrillation Clopidogrel Trial with Irbesartan for prevention of Vascular Events (ACTIVE W): a randomised controlled trial. Lancet 2006; 367(9526): 1903 - 1912.</mixed-citation><mixed-citation xml:lang="en">The ACTIVE Writing Group. Clopidogrel plus aspirin versus oral anticoagulation for atrial fibrillation in the Atrial fibrillation Clopidogrel Trial with Irbesartan for prevention of Vascular Events (ACTIVE W): a randomised controlled trial. Lancet 2006; 367(9526): 1903 - 1912.</mixed-citation></citation-alternatives></ref><ref id="cit8"><label>8</label><citation-alternatives><mixed-citation xml:lang="ru">Giliarov M.Iu., Generozov É.V., Magomadova M.U. et al. Factors influencing on warfarin dose in patients with atrial fibrillation. Kardiologiya i serdechno-sosudistaya khirurgiya 2008; 5: 65 - 68. Russian (Гиляров М.Ю., Генерозов Э.В., Магомадова М.У. и др. Факторы, влияющие на дозировку варфарина у пациентов с фибрилляцией предсердий. Кардиология и сердечно-сосудистая хирургия 2008; 5: 65 – 68).</mixed-citation><mixed-citation xml:lang="en">Giliarov M.Iu., Generozov É.V., Magomadova M.U. et al. Factors influencing on warfarin dose in patients with atrial fibrillation. Kardiologiya i serdechno-sosudistaya khirurgiya 2008; 5: 65 - 68. Russian (Гиляров М.Ю., Генерозов Э.В., Магомадова М.У. и др. Факторы, влияющие на дозировку варфарина у пациентов с фибрилляцией предсердий. Кардиология и сердечно-сосудистая хирургия 2008; 5: 65 – 68).</mixed-citation></citation-alternatives></ref><ref id="cit9"><label>9</label><citation-alternatives><mixed-citation xml:lang="ru">Giliarov M.Iu., Generozov É.V., Magomadova M.U. et al. Polymorphism of vitamin K epoxide-reductase subunit 1 gene: prevalence and impact on warfarin dosage among Moscow region inhabitants. Kardiologiya i serdechno-sosudistaya khirurgiya 2009; 3: 36 - 39. Russian (Гиляров М.Ю., Генерозов Э.В., Магомадова М.У. и др. Полиморфизм гена субъединицы 1 витамин К эпоксидредуктазы: распространенность и влияние на дозировку варфарина у жителей Московского региона. Кардиология и сердечно-сосудистая хирургия 2009; 3: 36 – 39).</mixed-citation><mixed-citation xml:lang="en">Giliarov M.Iu., Generozov É.V., Magomadova M.U. et al. Polymorphism of vitamin K epoxide-reductase subunit 1 gene: prevalence and impact on warfarin dosage among Moscow region inhabitants. Kardiologiya i serdechno-sosudistaya khirurgiya 2009; 3: 36 - 39. Russian (Гиляров М.Ю., Генерозов Э.В., Магомадова М.У. и др. Полиморфизм гена субъединицы 1 витамин К эпоксидредуктазы: распространенность и влияние на дозировку варфарина у жителей Московского региона. Кардиология и сердечно-сосудистая хирургия 2009; 3: 36 – 39).</mixed-citation></citation-alternatives></ref><ref id="cit10"><label>10</label><citation-alternatives><mixed-citation xml:lang="ru">The ACTIVE Investigators. Effect of Clopidogrel Added to Aspirin in Patients with Atrial Fibrillation. N Engl J Med 2009; 360(20): 2066 - 2078.</mixed-citation><mixed-citation xml:lang="en">The ACTIVE Investigators. Effect of Clopidogrel Added to Aspirin in Patients with Atrial Fibrillation. N Engl J Med 2009; 360(20): 2066 - 2078.</mixed-citation></citation-alternatives></ref><ref id="cit11"><label>11</label><citation-alternatives><mixed-citation xml:lang="ru">Cleland J.G.F., Cowburn P.J., Falk R.H. Should all patients with atrial fibrillation receive warfarin? Evidence from randomized clinical trials. Eur Heart J 1996; 17(5): 674 - 681.</mixed-citation><mixed-citation xml:lang="en">Cleland J.G.F., Cowburn P.J., Falk R.H. Should all patients with atrial fibrillation receive warfarin? Evidence from randomized clinical trials. Eur Heart J 1996; 17(5): 674 - 681.</mixed-citation></citation-alternatives></ref><ref id="cit12"><label>12</label><citation-alternatives><mixed-citation xml:lang="ru">Hylek E.M., Skates S.J., Sheehan M.A., Singer D.E. An Analysis of the Lowest Effective Intensity of Prophylactic Anticoagulation for Patients with Nonrheumatic Atrial Fibrillation. N Engl J Med 1996; 335(8): 540 - 546.</mixed-citation><mixed-citation xml:lang="en">Hylek E.M., Skates S.J., Sheehan M.A., Singer D.E. An Analysis of the Lowest Effective Intensity of Prophylactic Anticoagulation for Patients with Nonrheumatic Atrial Fibrillation. N Engl J Med 1996; 335(8): 540 - 546.</mixed-citation></citation-alternatives></ref><ref id="cit13"><label>13</label><citation-alternatives><mixed-citation xml:lang="ru">Gilyarov M.Yu., Sulimov V.A. Antithrombotic therapy at an atrial fibrillation: old problems and new solutions. Rational Pharmacother Cardiol 2010;6(1):84-88. Russian (Гиляров М.Ю., Сулимов В.А. Антитромботическая терапия при фибрилляции предсердий: старые проблемы и новые решения. Рациональная Фармакотерапия в Кардиологии 2010; 6(1): 84-88).</mixed-citation><mixed-citation xml:lang="en">Gilyarov M.Yu., Sulimov V.A. Antithrombotic therapy at an atrial fibrillation: old problems and new solutions. Rational Pharmacother Cardiol 2010;6(1):84-88. Russian (Гиляров М.Ю., Сулимов В.А. Антитромботическая терапия при фибрилляции предсердий: старые проблемы и новые решения. Рациональная Фармакотерапия в Кардиологии 2010; 6(1): 84-88).</mixed-citation></citation-alternatives></ref><ref id="cit14"><label>14</label><citation-alternatives><mixed-citation xml:lang="ru">Connolly S.J., Ezekowitz M.D., Yusuf S. et al. Dabigatran versus Warfarin in Patients with Atrial Fibrillation. N Engl J Med 2009; 361(12): 1139 - 1151.</mixed-citation><mixed-citation xml:lang="en">Connolly S.J., Ezekowitz M.D., Yusuf S. et al. Dabigatran versus Warfarin in Patients with Atrial Fibrillation. N Engl J Med 2009; 361(12): 1139 - 1151.</mixed-citation></citation-alternatives></ref><ref id="cit15"><label>15</label><citation-alternatives><mixed-citation xml:lang="ru">Connolly S.J., Ezekowitz M.D., Yusuf S. et al. Newly Identified Events in the RE-LY Trial. N Engl J Med 2010; 363(19): 1875 - 1876.</mixed-citation><mixed-citation xml:lang="en">Connolly S.J., Ezekowitz M.D., Yusuf S. et al. Newly Identified Events in the RE-LY Trial. N Engl J Med 2010; 363(19): 1875 - 1876.</mixed-citation></citation-alternatives></ref><ref id="cit16"><label>16</label><citation-alternatives><mixed-citation xml:lang="ru">Healey J.S., Eikelboom J., Wallentin L. et al. Effect of age and renal function on the risk of stroke and major bleeding with dabigatran compared to warfarin: an analysis from the RE-LY study. JACC 2010; 55: A4. E37.</mixed-citation><mixed-citation xml:lang="en">Healey J.S., Eikelboom J., Wallentin L. et al. Effect of age and renal function on the risk of stroke and major bleeding with dabigatran compared to warfarin: an analysis from the RE-LY study. JACC 2010; 55: A4. E37.</mixed-citation></citation-alternatives></ref><ref id="cit17"><label>17</label><citation-alternatives><mixed-citation xml:lang="ru">Oldgren J., Alings M., Darius H. et al. Dabigatran versus warfarin in atrial fibrillation patients with low, moderate and high CHADS2 score: a RE-LY subgroup analysis. JACC 2010; 55: A1. E2.</mixed-citation><mixed-citation xml:lang="en">Oldgren J., Alings M., Darius H. et al. Dabigatran versus warfarin in atrial fibrillation patients with low, moderate and high CHADS2 score: a RE-LY subgroup analysis. JACC 2010; 55: A1. E2.</mixed-citation></citation-alternatives></ref><ref id="cit18"><label>18</label><citation-alternatives><mixed-citation xml:lang="ru">Diener H.-C., Connolly S.J., Ezekowitz M.D. et al. Dabigatran compared with warfarin in patients with atrial fibrillation and previous transient ischaemic attack or stroke: a subgroup analysis of the RE-LY trial. Lancet Neurology 2010; 9(12): 1157 - 1163.</mixed-citation><mixed-citation xml:lang="en">Diener H.-C., Connolly S.J., Ezekowitz M.D. et al. Dabigatran compared with warfarin in patients with atrial fibrillation and previous transient ischaemic attack or stroke: a subgroup analysis of the RE-LY trial. Lancet Neurology 2010; 9(12): 1157 - 1163.</mixed-citation></citation-alternatives></ref><ref id="cit19"><label>19</label><citation-alternatives><mixed-citation xml:lang="ru">Lane D.A., Lip G.Y.H. Dabigatran in atrial fibrillation: balancing secondary stroke prevention against bleeding risk. Lancet Neurology 2010; 9(12): 1140 - 1142.</mixed-citation><mixed-citation xml:lang="en">Lane D.A., Lip G.Y.H. Dabigatran in atrial fibrillation: balancing secondary stroke prevention against bleeding risk. Lancet Neurology 2010; 9(12): 1140 - 1142.</mixed-citation></citation-alternatives></ref><ref id="cit20"><label>20</label><citation-alternatives><mixed-citation xml:lang="ru">Ezekowitz M.D., Wallentin L., Connolly S.J. et al. Comparison between the effects of dabigatran versus warfarin in Vitamin K antagonist naive and experienced patients with atrial fibrillation in the the RE-LY Trial. Circulation 2010; 122(22): 2246 - 2253.</mixed-citation><mixed-citation xml:lang="en">Ezekowitz M.D., Wallentin L., Connolly S.J. et al. Comparison between the effects of dabigatran versus warfarin in Vitamin K antagonist naive and experienced patients with atrial fibrillation in the the RE-LY Trial. Circulation 2010; 122(22): 2246 - 2253.</mixed-citation></citation-alternatives></ref><ref id="cit21"><label>21</label><citation-alternatives><mixed-citation xml:lang="ru">Wallentin L., Yusuf S., Ezekowitz M.D. et al. Efficacy and safety of dabigatran compared with warfarin at different levels of international normalised ratio control for stroke prevention in atrial fibrillation: an analysis of the RE-LY trial. Lancet 2010; 376(9745): 975 - 983.</mixed-citation><mixed-citation xml:lang="en">Wallentin L., Yusuf S., Ezekowitz M.D. et al. Efficacy and safety of dabigatran compared with warfarin at different levels of international normalised ratio control for stroke prevention in atrial fibrillation: an analysis of the RE-LY trial. Lancet 2010; 376(9745): 975 - 983.</mixed-citation></citation-alternatives></ref><ref id="cit22"><label>22</label><citation-alternatives><mixed-citation xml:lang="ru">Nagarakanti R., Ezekowitz M.D., Oldgren J. at al. Dabigatran versus warfarin in patients with atrial fibrillation: an analysis of patients undergoing cardioversion. Circulation 2011; 123(2):131-6.</mixed-citation><mixed-citation xml:lang="en">Nagarakanti R., Ezekowitz M.D., Oldgren J. at al. Dabigatran versus warfarin in patients with atrial fibrillation: an analysis of patients undergoing cardioversion. Circulation 2011; 123(2):131-6.</mixed-citation></citation-alternatives></ref><ref id="cit23"><label>23</label><citation-alternatives><mixed-citation xml:lang="ru">Roskel N.S., Lip G.Y.H., Noak H. et al. Treatments for stroke prevention in atrial fibrillation: A network meta-analyses and indirect comparisons versus dabigatran etexilate. Thromb Haemost 2010; 104(6): 1106 - 1115.</mixed-citation><mixed-citation xml:lang="en">Roskel N.S., Lip G.Y.H., Noak H. et al. Treatments for stroke prevention in atrial fibrillation: A network meta-analyses and indirect comparisons versus dabigatran etexilate. Thromb Haemost 2010; 104(6): 1106 - 1115.</mixed-citation></citation-alternatives></ref><ref id="cit24"><label>24</label><citation-alternatives><mixed-citation xml:lang="ru">Ahrens I., Lip G.Y., Peter K. What do the RE-LY, AVERROES and ROCKET-AF trials tell us for stroke prevention in atrial fibrillation? Thromb Haemost 2011;105(4). [Epub ahead of print].</mixed-citation><mixed-citation xml:lang="en">Ahrens I., Lip G.Y., Peter K. What do the RE-LY, AVERROES and ROCKET-AF trials tell us for stroke prevention in atrial fibrillation? Thromb Haemost 2011;105(4). [Epub ahead of print].</mixed-citation></citation-alternatives></ref><ref id="cit25"><label>25</label><citation-alternatives><mixed-citation xml:lang="ru">Lopes R.D., Alexander J.H., Al-Khatib S.M. et al.; ARISTOTLE Investigators. Apixaban for reduction in stroke and other ThromboemboLic events in atrial fibrillation (ARISTOTLE) trial: design and rationale. Am Heart J 2010;159(3):331-9.</mixed-citation><mixed-citation xml:lang="en">Lopes R.D., Alexander J.H., Al-Khatib S.M. et al.; ARISTOTLE Investigators. Apixaban for reduction in stroke and other ThromboemboLic events in atrial fibrillation (ARISTOTLE) trial: design and rationale. Am Heart J 2010;159(3):331-9.</mixed-citation></citation-alternatives></ref></ref-list><fn-group><fn fn-type="conflict"><p>The authors declare that there are no conflicts of interest present.</p></fn></fn-group></back></article>
