Prevention of ischemic stroke in atrial fibrillation from the point of view of a neurologist. Standards and real clinical practice
- Authors: Maksimova M.Y.1, Fonyakin A.V.1, Geraskina L.A.1
-
Affiliations:
- Research Center of Neurology
- Issue: Vol 93, No 10 (2021)
- Pages: 1240-1245
- Section: Reviews
- URL: https://journals.rcsi.science/0040-3660/article/view/87148
- DOI: https://doi.org/10.26442/00403660.2021.10.201105
- ID: 87148
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Abstract
The article outlines aspects of the current state of the problem of the priority choice of an oral anticoagulant for indefinite prevention of stroke and systemic thromboembolism in patients with atrial fibrillation. The advantages of direct oral angicoagulants over warfarin are presented, as well as a comparative analysis of the individual characteristics of the main direct oral angicoagulants from the point of view of personification of preventive therapy in accordance with modern treatment standards. The efficacy and safety of oral anticoagulant therapy has been reviewed in terms of the net clinical benefit. Particular attention is paid to the age-related aspects of choosing an anticoagulant for indefinite prophylaxis; an assessment of anticoagulants is presented in accordance with the FORTA concept, which regulates the use of drugs in elderly patients. In conclusion, recommendations are formulated for the choice of an anticoagulant in patients with atrial fibrillation in the most common clinical situations. As a general rule, the choice of a particular drug should be individualized based on risk factors, tolerability, net clinical benefit, patient preference, potential adverse interactions, and other clinical characteristics.
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##article.viewOnOriginalSite##About the authors
Marina Yu. Maksimova
Research Center of Neurology
Email: fonyakin@mail.ru
ORCID iD: 0000-0002-7682-6672
д-р мед. наук, проф., зав. 2-м неврологическим отд-нием
Russian Federation, MoscowAndrei V. Fonyakin
Research Center of Neurology
Author for correspondence.
Email: fonyakin@mail.ru
ORCID iD: 0000-0001-5452-2152
д-р мед. наук, проф., вед. науч. сотр., рук. лаб. кардионеврологии 2-го неврологического отд-ния
Russian Federation, MoscowLiudmila A. Geraskina
Research Center of Neurology
Email: fonyakin@mail.ru
ORCID iD: 0000-0002-1253-1082
д-р мед. наук, проф., вед. науч. сотр. лаб. кардионеврологии 2-го неврологического отд-ния
Russian Federation, MoscowReferences
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