uzspbgmuУчёные записки Первого Санкт-Петербургского государственного медицинского университета имени академика И. П. ПавловаThe Scientific Notes of the Pavlov University1607-41812541-8807Academician I.P. Pavlov First St. Petersburg State Medical University10.24884/1607-4181-2019-26-3-43-56uzspbgmu-658Research ArticleОБЗОРЫ И ЛЕКЦИИREVIEWS AND LECTURESБезопасность лечения прямыми оральными антикоагулянтами больных с фибрилляцией предсердий и высоким риском инсульта (обзор литературы)Safety of direct oral anticoagulants in patients with atrial fibrillation and high risk of stroke (review of literature)https://orcid.org/0000-0001-9638-2303БарановаЕ. И.BaranovaE. I.

Баранова Елена Ивановна, профессор, кафедра терапии факультетской с курсом эндокринологии, кардиологии и функциональной диагностики

197022, Санкт-Петербург, ул. Льва Толстого, д. 6-8.

6-8, L. Tolstoy str., Saint Petersburg, 197022.

baranova.grant2015@yandex.ruhttps://orcid.org/0000-0001-7293-1144ИонинВ. А.IoninV. A.

Ионин Валерий Александрович, доцент, кафедра терапии факультетской с курсом эндокринологии, кардиологии и функциональной диагностики

197022, Санкт-Петербург, ул. Льва Толстого, д. 6-8.

6-8, L. Tolstoy str., Saint Petersburg, 197022.

ionin.v.a@gmail.comhttps://orcid.org/0000-0003-2698-7977КацапА. А.KatsapA. A.

Кацап Анна Александровна, доцент, кафедра терапии факультетской с курсом эндокринологии, кардиологии и функциональной диагностики

197022, Санкт-Петербург, ул. Льва Толстого, д. 6-8.

6-8, L. Tolstoy str., Saint Petersburg, 197022.

annakatsap@inbox.ruhttps://orcid.org/0000-0002-0668-2490КолесникО. С.KolesnikO. S.

Колесник Ольга Степановна, доцент, кафедра терапии факультетской с курсом эндокринологии, кардиологии и функциональной диагностики

197022, Санкт-Петербург, ул. Льва Толстого, д. 6-8.

6-8, L. Tolstoy str., Saint Petersburg, 197022.

oleskol@inbox.ruhttps://orcid.org/0000-0001-6369-7149ЛебедеваЕ. В. LebedevaE. V.

Лебедева Елена Владимировна, доцент, кафедра терапии факультетской с курсом эндокринологии, кардиологии и функциональной диагностики

197022, Санкт-Петербург, ул. Льва Толстого, д. 6-8.

6-8, L. Tolstoy str., Saint Petersburg, 197022.

lebedeva-evl@mail.ruФедеральное государственное бюджетное образовательное учреждение высшего образования «Первый Санкт-Петербургский государственный медицинский университет имени академика И. П. Павлова» Министерства здравоохранения Российской ФедерацииРоссияPavlov UniversityRussian Federation2019041020192634356Copyright © Баранова Е.И., Ионин В.А., Кацап А.А., Колесник О.С., Лебедева Е.В., 20202020Баранова Е.И., Ионин В.А., Кацап А.А., Колесник О.С., Лебедева Е.В.Baranova E.I., Ionin V.A., Katsap A.A., Kolesnik O.S., Lebedeva 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.sci-notes.ru/jour/article/view/658

Литературный обзор посвящен проблеме безопасности применения прямых оральных антикоагулянтов у больных с неклапанной фибрилляцией предсердий. Обсуждаются критерии оценки риска кровотечений на фоне терапии антикоагулянтами, способы предупреждения больших кровотечений (внутричерепных, желудочно-кишечных) на фоне этой терапии, а также тактика ведения больных с кровотечениями, возникшими на фоне прямых оральных антикоагулянтов. Особое внимание уделяется выбору прямого орального антикоагулянта, значению доступного антагониста действия дабигатрана – идаруцизумаба, показаниям к применению этого препарата.

Review discusses the problem of non-vitamin K antagonist oral anticoagulants safety in patients with non-valvular atrial fibrillation. Bleeding risk assessment while applying anticoagulant therapy, preventive methods for major bleeding (intracranial, gastro-intestinal) during this therapy as well as the strategy of treating patients with bleedings occurring on direct oral anticoagulants intake are discussed in this review. Special attention is paid to the choice of direct oral anticoagulant, the importance of specific antagonist of dabigatran – idarucizumab and indications for its clinical application.

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