Статья
Желудочно-кишечные кровотечения с точки зрения кардиолога
Пероральная антикоагулянтная терапия широко используется у различных пациентов для профилактики и лечения тромбоэмболических состояний: при фибрилляции предсердий, тромбозе глубоких вен/тромбоэмболии лёгочной артерии, остром коронарном синдроме, в послеоперационном периоде у больных, перенесших ортопедические хирургические вмешательства. В настоящее время с целью длительной антикоагуляции возможно применение как антагонистов витамина К (варфарина), так и прямых оральных антикоагулянтов (ПОАК): дабигатрана, ривароксабана, апиксабана и эдоксабана. Основным осложнением любой антикоагулянтной терапии являются кровотечения (желудочно-кишечные, внутричерепные и др.), что серьёзно ограничивает её применение. В настоящем обзоре на основе результатов как крупных рандомизированных, так и пострегистрационных исследований проведён анализ встречаемости желудочно-кишечных кровотечений (ЖКК) на фоне приёма различных пероральных антикоагулянтов. Кроме этого, обсуждается влияние возраста на риск развития ЖКК, а также рассматриваются аспекты патофизиологии поражения слизистой желудочно-кишечного тракта при приёме ПОАК.
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