STATE OF THE UPPER DEPARTMENTS OF THE GASTROINTESTINAL TRACT IN PATIENTS WITH ISCHEMIC HEART DIS- EASE ON THE BACKGROUND OF RECEPTION OF ORAL ANTIAGREGANTS AND ANTICOAGULANTS

An analysis of 120 case histories of patients hospitalized in the clinic of the hospital therapy of S.M. Kirov Military medical academy for 2018 with various forms of coronary heart disease, among which 30 patients were diagnosed with angina pectoris, 11 had myocardial infarction, 30 had post-infarction cardiosclerosis, and 50 patients had a constant form of atrial fibrillation. 70.8% of patients had hypertension. 120 patients showed a high risk of developing thromboembolic complications, and therefore they were prescribed oral anticoagulants and / or antiplatelet therapy. The presence of lesions of the upper gastrointestinal tract was revealed in all patients with coronary heart disease taking antiplatelet and / or anticoagulant therapy. The analysis of the results of fibroesophagogastroduodenoscopy revealed the following diseases of the upper gastrointestinal tract: esophagitis reflux in 28.33% of patients, including erosive - 1.67%, chronic gastritis - in 59.17%, including erosive 10.8% peptic ulcer - 12.5%. In order to treat and prevent erosive and ulcerative bleeding from the upper gastrointestinal tract, only 42.5% of patients were prescribed drugs from the group of proton pump inhibitors. Thus, it is advisable for patients with various forms of coronary heart disease and a high risk of cardioembolic complications to start treatment with oral antiplatelet agents and / or anticoagulants with fibroesophagogastroduodenoscopy to timely identify the pathology of the esophagus, stomach and duodenum, and it is also necessary to conduct fibroesophagastroduodenoscopy in dynamics for timely detection of pathology, treatment and reduction of the risk of erosive and ulcerative bleeding. In order to treat and prevent erosive and ulcerative changes in the upper gastrointestinal tract in patients with coronary heart disease, drugs from the group of proton pump inhibitors for long-term use should be prescribed simultaneously with oral anticoagulants and / or antiplatelet agents.

coronary heart disease, anticoagulants, antiplatelet agents, gastrointestinal tract, non-steroidal anti-inflammatory drugs, peptic ulcer, bleeding