<?xml version="1.0" encoding="UTF-8"?>
<!DOCTYPE article PUBLIC "-//NLM//DTD JATS (Z39.96) Journal Publishing DTD v1.3 20210610//EN" "JATS-journalpublishing1-3.dtd">
<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="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">medsovet</journal-id><journal-title-group><journal-title xml:lang="ru">Медицинский Совет</journal-title><trans-title-group xml:lang="en"><trans-title>Meditsinskiy sovet = Medical Council</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2079-701X</issn><issn pub-type="epub">2658-5790</issn><publisher><publisher-name>REMEDIUM GROUP Ltd.</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.21518/2079-701X-2015-2-36-45</article-id><article-id custom-type="elpub" pub-id-type="custom">medsovet-117</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="ru"><subject>КАРДИОЛОГИЯ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>CARDIOLOGY</subject></subj-group></article-categories><title-group><article-title>Баланс эффективности и безопасности профилактики инсульта при неклапанной фибрилляции предсердий: возможности апиксабана. Вопросы и ответы</article-title><trans-title-group xml:lang="en"><trans-title>Balance of efficacy and safety in the prevention of stroke in patients with non-valvular atrial fibrillation: potential of apixaban. Questions and answers</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>Явелов</surname><given-names>И. С.</given-names></name><name name-style="western" xml:lang="en"><surname>Yavelov</surname><given-names>I. S.</given-names></name></name-alternatives><email xlink:type="simple">noemail@neicon.ru</email><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>Российский Национальный Исследовательский Медицинский Университет им. Н.И. Пирогова, Москва</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Pirogov Russian National Research Medical University</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2015</year></pub-date><pub-date pub-type="epub"><day>30</day><month>12</month><year>2015</year></pub-date><volume>0</volume><issue>2</issue><fpage>36</fpage><lpage>45</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Явелов И.С., 2015</copyright-statement><copyright-year>2015</copyright-year><copyright-holder xml:lang="ru">Явелов И.С.</copyright-holder><copyright-holder xml:lang="en">Yavelov I.S.</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.med-sovet.pro/jour/article/view/117">https://www.med-sovet.pro/jour/article/view/117</self-uri><abstract><p>Тромбоэмболические нарушения представляют серьезную проблему здравоохранения. Одно из наиболее значимых заболеваний, ассоциированных с тромбозом и имеющих серьезные клинические последствия, является инсульт. Фибрилляция предсердий увеличивает частоту возникновения инсульта, что определяет актуальность антикоагуляции при этом заболевании. В последнее время для профилактики тромбозов все большее распространение приобретают новые пероральные антикоагулянты. В связи с этим предлагаем обсудить некоторые вопросы применения антикоагулянтов для профилактики инсульта при фибрилляции предсердий.</p></abstract><trans-abstract xml:lang="en"><p>Stroke is one of the most serious cardiovascular events with severe consequences, up to paralysis and death. Patients at high risk of stroke include those with atrial fibrillation; in such patients prevention of stroke is particularly relevant. The article discusses the main issues of efficacy and safety of apixaban for the prevention of stroke in patients with non-valvular atrial fibrillation.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>stroke</kwd><kwd>atrial fibrillation</kwd><kwd>new oral anticoagulants</kwd><kwd>apixaban</kwd><kwd>инсульт</kwd><kwd>фибрилляция предсердий</kwd><kwd>новые оральные антикоагулянты</kwd><kwd>апиксабан</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">Guidelines for the management of atrial fibrillation. The Task Force for the Management of Atrial Fibrillation of the European Society of Cardiology (ESC). Eur Heart J., 2010, 31: 23692429.</mixed-citation><mixed-citation xml:lang="en">Guidelines for the management of atrial fibrillation. The Task Force for the Management of Atrial Fibrillation of the European Society of Cardiology (ESC). Eur Heart J., 2010, 31: 23692429.</mixed-citation></citation-alternatives></ref><ref id="cit2"><label>2</label><citation-alternatives><mixed-citation xml:lang="ru">focused update of the ESC Guidelines for the management of atrial fibrillation. An update of the 2010 ESC Guidelines for the management of atrial fibrillation. Developed with the special contribution of the European Heart Rhythm Association. Europace, 2012, 14: 1385-1413.</mixed-citation><mixed-citation xml:lang="en">focused update of the ESC Guidelines for the management of atrial fibrillation. An update of the 2010 ESC Guidelines for the management of atrial fibrillation. Developed with the special contribution of the European Heart Rhythm Association. Europace, 2012, 14: 1385-1413.</mixed-citation></citation-alternatives></ref><ref id="cit3"><label>3</label><citation-alternatives><mixed-citation xml:lang="ru">AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation. A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the Heart Rhythm Society. Circulation, 2014, 130: 20712104.</mixed-citation><mixed-citation xml:lang="en">AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation. A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the Heart Rhythm Society. Circulation, 2014, 130: 20712104.</mixed-citation></citation-alternatives></ref><ref id="cit4"><label>4</label><citation-alternatives><mixed-citation xml:lang="ru">Chao TF, Liu CJ, Wang KL et al. Should Atrial Fibrillation Patients With 1 Additional Risk Factor of the CHA2DS2-VASc Score (Beyond Sex) Receive Oral Anticoagulation? JACC, 2015, 65: 635-642.</mixed-citation><mixed-citation xml:lang="en">Chao TF, Liu CJ, Wang KL et al. Should Atrial Fibrillation Patients With 1 Additional Risk Factor of the CHA2DS2-VASc Score (Beyond Sex) Receive Oral Anticoagulation? JACC, 2015, 65: 635-642.</mixed-citation></citation-alternatives></ref><ref id="cit5"><label>5</label><citation-alternatives><mixed-citation xml:lang="ru">You JJ, Singer DE, Howard PA et al. Antithrombotic Therapy for Atrial Fibrillation. Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest, 2012, 141: 531S-575S.</mixed-citation><mixed-citation xml:lang="en">You JJ, Singer DE, Howard PA et al. Antithrombotic Therapy for Atrial Fibrillation. Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest, 2012, 141: 531S-575S.</mixed-citation></citation-alternatives></ref><ref id="cit6"><label>6</label><citation-alternatives><mixed-citation xml:lang="ru">Hart RG, Benavente O, McBride R, Pearce LA. Antithrombotic Therapy To Prevent Stroke in Patients with Atrial Fibrillation: A Meta-Analysis. Ann Intern Med., 1999; 131: 492-501.</mixed-citation><mixed-citation xml:lang="en">Hart RG, Benavente O, McBride R, Pearce LA. Antithrombotic Therapy To Prevent Stroke in Patients with Atrial Fibrillation: A Meta-Analysis. Ann Intern Med., 1999; 131: 492-501.</mixed-citation></citation-alternatives></ref><ref id="cit7"><label>7</label><citation-alternatives><mixed-citation xml:lang="ru">Hart RG, Pearce LA, Aguilar MI. Meta-analysis: Antithrombotic Therapy to Prevent Stroke in Patients Who Have Nonvalvular Atrial Fibrillation. Ann Intern Med 2007, 146: 857-867,</mixed-citation><mixed-citation xml:lang="en">Hart RG, Pearce LA, Aguilar MI. Meta-analysis: Antithrombotic Therapy to Prevent Stroke in Patients Who Have Nonvalvular Atrial Fibrillation. Ann Intern Med 2007, 146: 857-867,</mixed-citation></citation-alternatives></ref><ref id="cit8"><label>8</label><citation-alternatives><mixed-citation xml:lang="ru">Connolly SJ, Eikelboom J, Joyner C et al. For the AVERROES Steering Committee and Investigators. Apixaban in patients with atrial fibrillation. N Engl J Med 2011, 364: 806-817,</mixed-citation><mixed-citation xml:lang="en">Connolly SJ, Eikelboom J, Joyner C et al. For the AVERROES Steering Committee and Investigators. Apixaban in patients with atrial fibrillation. N Engl J Med 2011, 364: 806-817,</mixed-citation></citation-alternatives></ref><ref id="cit9"><label>9</label><citation-alternatives><mixed-citation xml:lang="ru">The ACTIVE Writing Group on behalf of the ACTIVE Investigators. 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: 1903-1912.</mixed-citation><mixed-citation xml:lang="en">The ACTIVE Writing Group on behalf of the ACTIVE Investigators. 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: 1903-1912.</mixed-citation></citation-alternatives></ref><ref id="cit10"><label>10</label><citation-alternatives><mixed-citation xml:lang="ru">Hart RG, Diener H-C, Yang S et al. Intracranial Hemorrhage in Atrial Fibrillation Patients During Anticoagulation With Warfarin or Dabigatran. The RE-LY Trial. Stroke 2012, 43: 1511-1517.</mixed-citation><mixed-citation xml:lang="en">Hart RG, Diener H-C, Yang S et al. Intracranial Hemorrhage in Atrial Fibrillation Patients During Anticoagulation With Warfarin or Dabigatran. The RE-LY Trial. Stroke 2012, 43: 1511-1517.</mixed-citation></citation-alternatives></ref><ref id="cit11"><label>11</label><citation-alternatives><mixed-citation xml:lang="ru">Eikelboom JW, Connolly SJ, Hart RG et al. Balancing the benefits and risks of 2 doses of dabigatran compared with warfarin in atrial fibrillation. JACC, 2013, 62: 900-988.</mixed-citation><mixed-citation xml:lang="en">Eikelboom JW, Connolly SJ, Hart RG et al. Balancing the benefits and risks of 2 doses of dabigatran compared with warfarin in atrial fibrillation. JACC, 2013, 62: 900-988.</mixed-citation></citation-alternatives></ref><ref id="cit12"><label>12</label><citation-alternatives><mixed-citation xml:lang="ru">ACTIVE Writing Group of the ACTIVE Investigators. 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: 1903-1912.</mixed-citation><mixed-citation xml:lang="en">ACTIVE Writing Group of the ACTIVE Investigators. 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: 1903-1912.</mixed-citation></citation-alternatives></ref><ref id="cit13"><label>13</label><citation-alternatives><mixed-citation xml:lang="ru">Gomes T, Mamdani MM, Holbrook AM et al. Rates of hemorrhage during warfarin therapy for atrial fibrillation. CMAJ 2013, 185: 121-127.</mixed-citation><mixed-citation xml:lang="en">Gomes T, Mamdani MM, Holbrook AM et al. Rates of hemorrhage during warfarin therapy for atrial fibrillation. CMAJ 2013, 185: 121-127.</mixed-citation></citation-alternatives></ref><ref id="cit14"><label>14</label><citation-alternatives><mixed-citation xml:lang="ru">Azoulay L, Dell'Aniello S, Simon TA et al. Initiation of warfarin in patients with atrial fibrillation: early effects on ischaemic strokes. Eur Heart J 2014, 35: 1881-1887.</mixed-citation><mixed-citation xml:lang="en">Azoulay L, Dell'Aniello S, Simon TA et al. Initiation of warfarin in patients with atrial fibrillation: early effects on ischaemic strokes. Eur Heart J 2014, 35: 1881-1887.</mixed-citation></citation-alternatives></ref><ref id="cit15"><label>15</label><citation-alternatives><mixed-citation xml:lang="ru">Ghate SR, Biskupiak JE, Ye X et al. Hemorrhagic and Thrombotic Events Associated with Generic Substitution of Warfarin in Patients with Atrial Fibrillation: A Retrospective Analysis. Ann Pharmacother 2011, 45: 701-712.</mixed-citation><mixed-citation xml:lang="en">Ghate SR, Biskupiak JE, Ye X et al. Hemorrhagic and Thrombotic Events Associated with Generic Substitution of Warfarin in Patients with Atrial Fibrillation: A Retrospective Analysis. Ann Pharmacother 2011, 45: 701-712.</mixed-citation></citation-alternatives></ref><ref id="cit16"><label>16</label><citation-alternatives><mixed-citation xml:lang="ru">Granger CB, Alexander JH, McMurray JJ et al. For the ARISTOTLE Committees and Investigators. Apixaban versus warfarin in patients with atrial fibrillation. N Engl J Med, 2011, 365: 981-992.</mixed-citation><mixed-citation xml:lang="en">Granger CB, Alexander JH, McMurray JJ et al. For the ARISTOTLE Committees and Investigators. Apixaban versus warfarin in patients with atrial fibrillation. N Engl J Med, 2011, 365: 981-992.</mixed-citation></citation-alternatives></ref><ref id="cit17"><label>17</label><citation-alternatives><mixed-citation xml:lang="ru">Connolly SJ, Connolly SJ, Ezekowitz MD et al. For the RE-LY Steering Committee and Investigators. Dabigatran versus warfarin in patients with atrial fibrillation. N Engl J Med 2009? 361: 1139-1351.</mixed-citation><mixed-citation xml:lang="en">Connolly SJ, Connolly SJ, Ezekowitz MD et al. For the RE-LY Steering Committee and Investigators. Dabigatran versus warfarin in patients with atrial fibrillation. N Engl J Med 2009? 361: 1139-1351.</mixed-citation></citation-alternatives></ref><ref id="cit18"><label>18</label><citation-alternatives><mixed-citation xml:lang="ru">Patel MR, Mahaffey KW, Garg J et al. For the ROCKET-AF Investigators. Rivaroxaban versus warfarin in nonvalvular atrial fibrillation. N Engl J Med 2011, 365: 883-891.</mixed-citation><mixed-citation xml:lang="en">Patel MR, Mahaffey KW, Garg J et al. For the ROCKET-AF Investigators. Rivaroxaban versus warfarin in nonvalvular atrial fibrillation. N Engl J Med 2011, 365: 883-891.</mixed-citation></citation-alternatives></ref><ref id="cit19"><label>19</label><citation-alternatives><mixed-citation xml:lang="ru">Hylek EM, Held C, Alexander JH. et al. Major Bleeding in Patients with Atrial Fibrillation Receiving Apixaban or Warfarin in the ARISTOTLE Trial: Predictors, Characteristics, and Clinical Outcomes. JACC 2014, 63: 2141-2147.</mixed-citation><mixed-citation xml:lang="en">Hylek EM, Held C, Alexander JH. et al. Major Bleeding in Patients with Atrial Fibrillation Receiving Apixaban or Warfarin in the ARISTOTLE Trial: Predictors, Characteristics, and Clinical Outcomes. JACC 2014, 63: 2141-2147.</mixed-citation></citation-alternatives></ref><ref id="cit20"><label>20</label><citation-alternatives><mixed-citation xml:lang="ru">Lopes RD, Al-Khatib SM, Wallentin L et al. Efficacy and safety of apixaban compared with warfarin according to patient risk of stroke and of bleeding in atrial fibrillation: a secondary analysis of a randomized controlled trial. Lancet 2012, 380: 1749-1758.</mixed-citation><mixed-citation xml:lang="en">Lopes RD, Al-Khatib SM, Wallentin L et al. Efficacy and safety of apixaban compared with warfarin according to patient risk of stroke and of bleeding in atrial fibrillation: a secondary analysis of a randomized controlled trial. Lancet 2012, 380: 1749-1758.</mixed-citation></citation-alternatives></ref><ref id="cit21"><label>21</label><citation-alternatives><mixed-citation xml:lang="ru">Hohnloser SH, Hijazi Z, Thomas L et al. Efficacy of apixaban when compared with warfarin in relation to renal function in patients with atri-al fibrillation: insights from the ARISTOTLE trial. Eur Heart J 2012, 33: 2821-2830.</mixed-citation><mixed-citation xml:lang="en">Hohnloser SH, Hijazi Z, Thomas L et al. Efficacy of apixaban when compared with warfarin in relation to renal function in patients with atri-al fibrillation: insights from the ARISTOTLE trial. Eur Heart J 2012, 33: 2821-2830.</mixed-citation></citation-alternatives></ref><ref id="cit22"><label>22</label><citation-alternatives><mixed-citation xml:lang="ru">Wallentin L, Lopes RD, Hanna M et al. Efficacy and safety of apixaban compared with warfarin in different levels of predicted INR control for stroke prevention in atrial fibrillation. Circulation, 2013, 127: 2166-2176.</mixed-citation><mixed-citation xml:lang="en">Wallentin L, Lopes RD, Hanna M et al. Efficacy and safety of apixaban compared with warfarin in different levels of predicted INR control for stroke prevention in atrial fibrillation. Circulation, 2013, 127: 2166-2176.</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>
