Статья
ПОДХОДЫ К АНТИТРОМБОТИЧЕСКОЙ ТЕРАПИИ У ПАЦИЕНТОВ ПОЖИЛОГО ВОЗРАСТА C ФИБРИЛЛЯЦИЕЙ ПРЕДСЕРДИЙ
Пожилой возраст – наиболее важный и независимый фактор риска развития фибрилляции предсердий (ФП). Доля больных с ФП в возрасте 65-85 лет достигает 70%, а средний возраст пациентов с ФП составляет 75 лет. Антитромботическая терапия у пожилых затруднена в силу ряда причин. С одной стороны, у пожилых повышен риск развития системной эмболии и инсульта, а также фатальных исходов инсульта по сравнению с более молодыми пациентами. С другой стороны, у пожилых пациентов повышен риск кровотечений. Кроме того, они страдают сопутствующими заболеваниями и получают препараты, которые могут вступать во взаимодействия с антитромботическими средствами. В статье обсуждаются шкалы, применяемые для оценки риска тромбоэмболических и геморрагических осложнений и общие подходы к антитромботической терапии у пожилых пациентов.
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