Clinical recommendations compliance with for the administration of oral anticoagulants to patients of atrial fibrillation and a high risk of thromboembolic complications

Iureva Svetlana Vladimirovna, Baluyev Ivan Nikolaevich, Voronina Svetlana Sergeevna

Objective: to evaluate the frequency of prescribing novel oral anticoagulants (NOAC) to patients with non-valvular AF for the prevention of thromboembolic complications and stroke in outpatient practice. Materials and methods:Outpatient cards in outpatient polyclinic institutions of Arkhangelsk were analyzed. Inclusion criteria: age over 18 years, presence of AF in the main diagnosis of the disease, diagnosis confirmed by instrumental methods, high risk of thromboembolic complications. Individual questionnaires were developed for patients, which examined demographic data, the risk of developing a thromboembolic complications the CHA2DS2-VASc scale, the risk of bleeding on the HAS-BLED scale, also assessed the frequency of prescribing oral anticoagulants (vitamin K antagonists and NOAC) and the examination of patients before prescribing these groups of drugs. Results:Oral anticoagulants were prescribed only in 129 (43.6%) cases, of which 84 (28.4%) patients were prescribed warfarin (the proportion of time spent INR in the therapeutic range was 44.6%, and 45 (15.2%) patients were prescribed PPOAC: in 62.2% of cases (28 patients) were prescribed rivaroxaban, apixaban prescribed in 28.9% (13 patients), dabigatran in 8.9% (4 patients). Conclusion:the percentage of prescribing is still very low, while there is a tendency to unreasonably reduce the dose, despite the presence of modified bleeding risk factors, with a high risk of stroke on the CHA2DS2-VASc scale.

Keywords:atrial fibrillation, thromboembolic complications, oral anticoagulants, warfarin, apixaban, dabigatran, rivaroxaban.