medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2013-12-6-13medsovet-1156Research ArticleКардионеврологияCardioneurologyПрогноз и профилактика кардиоэмболического инсульта при фибрилляции предсердийPrognosis and prevention of cardioembolic stroke in patients with atrial fibrillationПарфеновВ. А.ParfyonovV. А.noemail@neicon.ruВербицкаяС. В.VerbitskayaS. V.noemail@neicon.ruПервый МГМУ им. И.М. СеченоваРоссияFirst MSMU named after I.M. SechenovRussian Federation201330122013012613Copyright © Парфенов В.А., Вербицкая С.В., 20132013Парфенов В.А., Вербицкая С.В.Parfyonov V.А., Verbitskaya S.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.med-sovet.pro/jour/article/view/1156

-VASc, рекомендуется использовать пероральные антикоагулянты. Представлены данные больших рандомизированных исследований, которые показали, что новые пероральные антикоагулянты (дабигатран, ривароксабан, апиксабан) не уступают варфарину или имеют преимущество в виде более существенного снижения риска инсульта и менее значительного риска больших, особенно внутричерепных, кровотечений. Отмечается положительный практический опыт использования дабигатрана (препарат Прадакса®) в дозе 150 мг или 110 мг два раза у пациентов с ФП. В нашей стране внедрение в неврологическую практику новых антикоагулянтов, прием которых не требует контроля с использованием международного нормализующего отношения, позволит более широко назначать антикоагулянтную терапию пациентам с ФП и снизить частоту развития кардиоэмболического инсульта.

The article is a review of literature on the prognosis and prevention of stroke in patients with atrial fibrillation (AF). It is noted that the simple CHA2DS2-VASc calculator is a good predictor of the risk of stroke in AF. Oral anticoagulants are recommended to patients with one or more risk factors for stroke according to CHA2DS2-VASc. There is data from large randomized trials showing that new oral anticoagulants (dabigatran, rivaroxaban, apixaban) can be as good as or better than warfarin in significantly reducing the risk of stroke, and are associated with lower risk of serious, particularly intracranial, bleeding. Positive experience related to the use of dabigatran (Pradaxa®), in a dose of 150 mg or 110 mg twice in patients with AF, is described. The introduction of new anticoagulants into the national neurological practice which do not require international normalized ratio control, will ensure wider use of anticoagulant therapy in patients with AF and reduce the incidence of cardioembolic stroke.

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