EXPERIENCE IN THE USE OF ORAL ANTICOAGULANTS IN OUTPATIENT CLINICS

Abstract

Since 2011, with the emergence of new classes of antithrombotic drugs – inhibitors of the activated X coagulation factor (rivoroxaban, apixaban, edoxaban) and thrombin inhibitor (dabigatran), antithrombotic therapy has received a new impetus to development and wider introduction into practice. New oral anticoagulants (NOAC) do not require laboratory monitoring for correction and dose selection, which makes their appointment more simple and convenient, compared with vitamin K antagonists (warfarin). The purpose of the presented work was to evaluate the efficacy and The safety of anticoagulant therapy in patients with atrial fibrillation in out-patient practice. The study was conducted for 1 year. There were 168 patients (108 men, 60 women, mean age 70. 6 ± 2.46 years) with atrial fibrillation. 90 patients received PLA (53% – dabigatran, 41% – rivaroxaban, 6% – apixaban), 78 – warfarin. 74% of patients included in the study had 3 or more points on the scale CHA2DS2-Vasc. During the observation period in the PLA group, ONMC was registered in 2 patients (2.2%), PE – 0. In 1 patient, embolism in the brachial artery was observed against the background of anticoagulant withdrawal due to the planned surgical intervention. In the group receiving warfarin as an anticoagulant, 2 strokes were registered during the year (2.3%) (1 of them fatal). The frequency of bleeding in the PLA group: large – 0, macrogematuria – 3, nasal 2, conjunctival – 2. In the warfarin group: large – 1 (fatal stratification of the aneurysm of the abdominal aorta), macrogemaria – 4, nasal 1, conjunctival – 1. Reliable differences in The frequency of bleeding was not revealed.