medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2017-7-56-62medsovet-1770Research ArticleТРОМБОЗЫ И ТРОМБОЭМБОЛИИTHROMBOSIS AND THROMBOEMBOLISMПЕРОРАЛЬНЫЕ АНТИКОАГУЛЯНТЫ В ЛЕЧЕНИИ ВЕНОЗНЫХ ТРОМБО- ЭМБОЛИЧЕСКИХ ОСЛОЖНЕНИЙ: ФОКУС НА АПИКСАБАНORAL ANTICOAGULANTS IN THE TREATMENT OF VENOUS THROMBOEMBOLIC COMPLICATIONS: FOCUS ON APIXABANГиляровМ. Ю.GilyarovM. Yu.

д.м.н., профессор, 

Москва

MD, Prof., 

Moscow

КонстантиноваЕ. В.KonstantinovaE. V.

д.м.н.,

Москва

MD,

Moscow

ГКБ №1 им. Н.И. Пирогова Департамента здравоохранения г. Москвы; Первый Московский государственный медицинский университет им. И.М. Сеченова Минздрава РоссииРоссияCity Clinical Hospital № 1 named after. N.I. Pirogov, Moscow Healthcare Department; First Moscow State Medical University named after I.M. Sechenov, MoH RFRussian FederationГКБ №1 им. Н.И. Пирогова Департамента здравоохранения г. Москвы; Российский национальный исследовательский медицинский университет им. Н.И. Пирогова Минздрава РоссииРоссияCity Clinical Hospital № 1 named after. N.I. Pirogov, Moscow Healthcare Department; Russian National Medical Research University named after N.I. Pirogov, MoH RFRussian Federation201730122017075662Copyright © Гиляров М.Ю., Константинова Е.В., 20172017Гиляров М.Ю., Константинова Е.В.Gilyarov M.Y., Konstantinova 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.med-sovet.pro/jour/article/view/1770

Проблема венозных тромбоэмболических осложнений (ВТЭО), включающая тромбоз глубоких вен нижних конечностей и тромбоэмболию легочной артерии, имеет большую медицинскую и социальную значимость. Основой лечения и профилак- тики ВТЭО является антикоагулянтная терапия. Согласно современным рекомендациям, терапия ВТЭО начинается с назначения парентеральных антикоагулянтов (низкомолекулярных гепаринов или фондапаринукса) и антагонистов витамина К (АВК), с последующим полным переходом исключительно на АВК. Неудобства проведения такой терапии послужили основанием для появления в клинической практике новых пероральных антикоагулянтов, блокирующих Xа фактор крови или тромбин, которые назначаются в фиксированной дозе и не требуют рутинного лабораторного контроля. В статье представлены результаты исследований апиксабана в лечении и профилактике ВТЭО, охарактеризованы его эффективность и безопасность у различных категорий больных, а также особенности его применения на практике.

Venous thromboembolism (VTE), comprising deep vein thrombosis and pulmonary embolism, is a common condition associated with a significant clinical and economic burden. Anticoagulant therapy is the mainstay of treatment for VTE. Current guidelines recommend the use of either low molecular weight heparins or fondaparinux overlapping with and followed by a vitamin K antagonist for the initial treatment of VTE, with the vitamin K antagonist continued when long-term anticoagulation is required. These traditional anticoagulants have practical limitations that have led to the development of direct oral anticoagulants that directly target either Factor Xa or thrombin and are administered at a fixed dose without the need for routine coagulation monitoring. The paper reviews results of the trials of apixaban application for treatment and/or long-term secondary prevention of VTE. The paper analyses effectiveness and safety of apixaban in different groups of patients, as well as features of apixaban application in every day practice.

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