Oral direct anticoagulants: what to do with hemorrhagic complications?


DOI: https://dx.doi.org/10.18565/therapy.2019.6.100-104

Berns S.A., Pasechnik I.N., Golikova A.A., Talyzin P.A., Putilina M.V., Volkov A.K., Zverev K.V.

1) A.I. Yevdokimov Moscow State University of medicine and dentistry of the Ministry of Healthcare of Russia; 2) Central State medical Academy of the Presidential Administration of the Russian Federation, Moscow; 3) M.E. Zhadkevich City clinical hospital of the Department of Healthcare of Moscow; 4) N.I. Pirogov Russian National research medical University of the Ministry of Healthcare of Russia, Moscow
Article discusses the problem of direct oral anticoagulants (PPAC) prescribing in patients with atrial fibrillation, and the arising complications. It was noted that PPAC administration carries a risk of developing hemorrhagic complications, which cannot be completely prevented. A progressively increasing number of patients receiving PPAC is associated with an increase of cases when anticoagulants need to be canceled. Moreover, according to real clinical practice, an older age group of patients has a comorbid pathology, often accompanied by polypragmasy. The reinitiation, dosing regimen and specific PPAC selection is remaining up to the physician’s opinion in a particular clinical situation.
Keywords: direct oral anticoagulants, anticoagulant therapy, hemorrhagic complications, atrial fibrillation
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About the Autors

Svetlana A. Berns, MD, professor of the Department of internal medicine of faculty of dentistry of A.I. Yevdokimov Moscow State University of medicine and dentistry of the Ministry of Healthcare of Russia. Address: 127473, Moscow, 20/1 Delegatskaya Str. E-mail: svberns@yandex.ru
Igor N. Pasechnik, MD, professor, head of the Department of anesthesiology and reanimatology of Central State medical Academy of the Presidential Administration of the Russian Federation. Address: 121359, Moscow, 19/1A Marshala Timoshenko Str. E-mail: pasigor@yandex.ru
Anna A. Golikova, MD, professor of the Department of internal diseases of the faculty of dentistry of A.I. Yevdokimov Moscow State University of medicine and dentistry of the Ministry of Healthcare of Russia. Address: 127473, Moscow, 20/1 Delegatskaya Str. E-mail: golikova.anna.1954@mail.ru
Pavel A. Talyzin, head of the Department of resuscitation and intensive care for CVA patients of M.E. Zhadkevich City clinical hospital of the Department of Healthcare of Moscow Address: 121374, Moscow, 14 Mozhayskoye Shosse Str. E-mail: talyzinpavel@yandex.com
Marina V. Putilina, MD, professor of the Department of clinical pharmacology of faculty of general medicine of N.I. Pirogov Russian National research medical University of the Ministry of Healthcare of Russia. Address: 117997, Moscow, 1 Ostrovityanova Str. E-mail: profput@mail.ru
Alexander–Christian Volkov, clinical resident of the Department of anesthesiology and reanimatology of Central State medical Academy of the Presidential Administration of the Russian Federation. Address: 121374, Moscow, 14 Mozhaiskoe Shosse Str. E-mail: 7498359@mail.ru
Konstantin V. Zverev, Deputy Chief Doctor for medical part of M.E. Zhadkevich City clinical hospital of the Department of Healthcare of Moscow. Address: 121374, Moscow, 14 Mozhaiskoe Shosse Str. E-Mail: 7498359@mail.ru


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