medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2017-10-6-11medsovet-1860Research ArticleЦЕРЕБРОВАСКУЛЯРНЫЕ ЗАБОЛЕВАНИЯCEREBROVASCULAR DISEASESФИБРИЛЛЯЦИЯ ПРЕДСЕРДИЙ У ПАЦИЕНТОВ С ГЕМОРРАГИЧЕСКИМ ИНСУЛЬТОМ: ПОДХОДЫ К АНТИКОАГУЛЯНТНОЙ ТЕРАПИИATRIAL FIBRILLATION IN PATIENTS WITH HEMORRHAGIC STROKE: APPROACHES TO ANTICOAGULANT THERAPYКулагинаА. М.KulaginaA. M.

Москва

Moscow

ЗоринаА. В.ZorinaA. V.

Москва

Moscow

ВиноградовО. И.VinogradovO. I.

Доктор медиинских наук.

Москва

MD.

Moscow

Национальный медико-хирургический центр им. Н.И. ПироговаРоссияNational Pirogov Centre of Therapy and Surgery, National Center of Cerebrovascular DisordersRussian Federation201724052017010611Copyright © Кулагина А.М., Зорина А.В., Виноградов О.И., 20172017Кулагина А.М., Зорина А.В., Виноградов О.И.Kulagina A.M., Zorina A.V., Vinogradov O.I.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/1860

Фибрилляция предсердий (ФП) – наиболее распространенное нарушение ритма сердца. ФП ассоциируется  с увеличением частоты госпитализаций, смертности, развития инсульта, сердечной недостаточности. Основой профилактики сердечно-сосудистых осложнений у больных ФП являются пероральные антикоагулянты. Однако использование антикоагулянтов повышает риск развития внутримозговых гематом. Особую группу больных, перенесших геморрагический инсульт, составляют пациенты с ФП. Данной категории больных, с одной стороны, показана антикоагулянтная терапия в связи с высоким риском развития тромбоэмболических  осложнений, с другой стороны, она противопоказана в связи с развитием геморрагического  инсульта. Оптимальный  режим  антитромботической терапии  до  конца  остается  неизвестным. Обсуждаются современные подходы к терапии ФП у больных, перенесших геморрагический инсульт.

The atrial fibrillation  (AF) is the most common disturbance of cardiac rhythm. The AF is associated with an increase in the rate of hospitalization, mortality, stroke development, heart failure. Oral anticoagulants are the basis for prevention of cardiovascular complications in the AF patients. However, the use of anticoagulants increases the risk of intracerebral hematoma. A special group of patients with hemorrhagic strokes are AF patients. Anticoagulant therapy is indicated for this category of patients, on the one hand, due to high risk of development of thromboembolic complications, on the other hand, it is contraindicated in connection with the development of hemorrhagic stroke. The optimum mode of antithrombotic therapy remains unknown. Current approaches to the AF therapy  for patients with hemorrhagic stroke are being discussed.

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