Возобновление терапии антикоагулянтами после крупного кровотечения и рецидивы геморрагических осложнений у больных фибрилляцией предсердий с высоким риском инсульта и тромбоэмболий (по результатам 20-летнего наблюдения)
Возобновление терапии антикоагулянтами после крупного кровотечения и рецидивы геморрагических осложнений у больных фибрилляцией предсердий с высоким риском инсульта и тромбоэмболий (по результатам 20-летнего наблюдения)
Миронова (Староверова) А.И., Панченко Е.П., Кропачева Е.С., Землянская О.А. Возобновление терапии антикоагулянтами после крупного кровотечения и рецидивы геморрагических осложнений у больных фибрилляцией предсердий с высоким риском инсульта и тромбоэмболий (по результатам 20-летнего наблюдения). Терапевтический архив. 2020; 92 (9): 15–23. DOI: 10.26442/00403660.2020.09.000655
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Аннотация
Цель. Анализ частоты возобновления терапии антикоагулянтами после случившихся больших и клинически значимых кровотечений среди пациентов с фибрилляцией предсердий (ФП), получавших пероральные антикоагулянты и наблюдавшихся в отделе клинических проблем атеротромбоза с 1999 по 2019 г. в рамках ретропроспективного регистра «Регата-2», а также поиск клинических факторов, ассоциированных с рецидивом геморрагических осложнений (ГО) среди пациентов, возобновивших терапию антикоагулянтами после эпизода кровотечения.
Материалы и методы. Исследование представляет собой анализ когорты больных ФП высокого тромботического риска с абсолютными показаниями к назначению антикоагулянтрой терапии (АКТ). В исследование включены 290 пациентов с ФП (130 женщин и 160 мужчин) в возрасте от 32 до 85 лет (средний возраст составил 65,18±8,89 года). За время наблюдения у 92 пациентов развились ГО, у 73 из них возобновлена АКТ. У 35 из 73 больных, возобновивших АКТ, развился рецидив большого/клинически значимого кровотечения.
Результаты. Частота возобновления АКТ после развития первого ГО увеличивалась с течением времени с 75% в период с 1999 по 2003 г. до 90% в период 2015–2019 гг. Нам не удалось установить точной связи между наличием сопутствующей патологии и принятием решения о возобновления АКТ после случившегося кровотечения. Единственной достоверной причиной отказа от возобновления АКТ стало категорическое нежелание больного. Среди пациентов, у которых рецидивировали ГО, сумма баллов по шкале коморбидности Чарльсона больше (4,23±2,01 vs 3,52±1,43; p=0,0425). Больные с рецидивирующими кровотечениями достоверно чаще страдали хронической болезнью почек со снижением скорости клубочковой фильтрации менее 60 мл/мин/1,73 м2, а также имели эрозивно-язвенное поражение желудочно-кишечного тракта в анамнезе. Также выявлена достоверная связь рецидива кровотечений с приемом ингибиторов протонной помпы. Подгруппы пациентов, перешедших с варфарина на прием прямых оральных антикоагулянтов после первого кровотечения и с последующими рецидивирующими кровотечениями по основным клиническим характеристикам не отличались от больных без кровотечений после смены антикоагулянта. По данным множественного регрессионного анализа прием нестероидных противовоспалительных препаратов показал тенденцию к развитию рецидива больших или клинически значимых кровотечений на фоне прямых оральных антикоагулянтов у больных, перенесших ГО на фоне терапии варфарином (b=0,4524; р=0,0530).
Заключение. За время 20-летнего наблюдения частота развития всех больших и клинически значимых кровотечений составила 2,6/100 пациенто-лет, частота развития первого кровотечения – 5,86/100 пациенто-лет, тогда как частота повторных ГО – 7,06/100 пациенто-лет. Больные с высоким тромбоэмболическим риском должны получать антикоагулянты при условии тщательной коррекции модифицируемых факторов риска кровотечений.
Ключевые слова: фибрилляция предсердий, антикоагулянтная терапия, варфарин, прямые оральные антикоагулянты, геморрагические осложнения, рецидивирующие кровотечения.
Materials and methods. In cohort study of patients with high-risk AF with absolute indications for ACT we enrolled 290 AF patients (130 women and 160 men) aged 32 to 85 years (the average age was 65.18±8.89 years). During the follow-up period, 92 patients developed hemorrhagic complications, and 73 of them resumed ACT. 35 of the 73 patients who resumed ACT developed a relapse of major/clinically significant bleeding.
Results. The frequency of resuming ACT after the first hemorrhagic complication increased over time from 75% in the period from 1999–2003 to 90% in the period 2015–2019. We were not able to establish an exact relationship between the presence of concomitant pathology and the decision to resume the ACT after bleeding. The only reliable reason for refusing to resume the ACT was the patient's categorical reluctance. Among patients who had recurrent hemorrhagic complications, the total score on the Charleson comorbidity scale was significantly higher (4.23±2.01 vs 3.52±1.43; p=0.0425). Patients with recurrent bleeding were significantly more likely to suffer from CKD with a decrease in GFR less than 60 ml/min/1.73 sq. m, and also had a history of erosive and ulcerative lesions of the gastrointestinal tract. There was also a significant Association of recurrent bleeding with the use of proton pump inhibitors. Subgroups of patients who switched from warfarin to taking direct oral anticoagulants after the first bleeding and subsequent recurrent bleeding did not differ in basic clinical characteristics from patients without bleeding after changing the anticoagulant. According to multiple regression analysis, NSAIDs showed a tendency to develop a relapse of B/C bleeding on the background of direct oral anticoagulants in patients who underwent GO on the background of warfarin therapy (b=0.4524, p=0.0530).
Conclusion. During the 20-year follow-up, the frequency of all major and clinically significant bleeding was 2.6/100 patients-years, the frequency of first bleeding was 5.86/100 patients-years, while the frequency of repeated hemorrhagic complications was 7.06/100 patients-years. Patients with a high thromboembolic risk should receive anticoagulants, provided that the modifiable risk factors for bleeding are carefully corrected.
Keywords: atrial fibrillation, anticoagulant therapy, warfarin, direct oral anticoagulants, hemorrhagic complications, recurrent bleeding.
Материалы и методы. Исследование представляет собой анализ когорты больных ФП высокого тромботического риска с абсолютными показаниями к назначению антикоагулянтрой терапии (АКТ). В исследование включены 290 пациентов с ФП (130 женщин и 160 мужчин) в возрасте от 32 до 85 лет (средний возраст составил 65,18±8,89 года). За время наблюдения у 92 пациентов развились ГО, у 73 из них возобновлена АКТ. У 35 из 73 больных, возобновивших АКТ, развился рецидив большого/клинически значимого кровотечения.
Результаты. Частота возобновления АКТ после развития первого ГО увеличивалась с течением времени с 75% в период с 1999 по 2003 г. до 90% в период 2015–2019 гг. Нам не удалось установить точной связи между наличием сопутствующей патологии и принятием решения о возобновления АКТ после случившегося кровотечения. Единственной достоверной причиной отказа от возобновления АКТ стало категорическое нежелание больного. Среди пациентов, у которых рецидивировали ГО, сумма баллов по шкале коморбидности Чарльсона больше (4,23±2,01 vs 3,52±1,43; p=0,0425). Больные с рецидивирующими кровотечениями достоверно чаще страдали хронической болезнью почек со снижением скорости клубочковой фильтрации менее 60 мл/мин/1,73 м2, а также имели эрозивно-язвенное поражение желудочно-кишечного тракта в анамнезе. Также выявлена достоверная связь рецидива кровотечений с приемом ингибиторов протонной помпы. Подгруппы пациентов, перешедших с варфарина на прием прямых оральных антикоагулянтов после первого кровотечения и с последующими рецидивирующими кровотечениями по основным клиническим характеристикам не отличались от больных без кровотечений после смены антикоагулянта. По данным множественного регрессионного анализа прием нестероидных противовоспалительных препаратов показал тенденцию к развитию рецидива больших или клинически значимых кровотечений на фоне прямых оральных антикоагулянтов у больных, перенесших ГО на фоне терапии варфарином (b=0,4524; р=0,0530).
Заключение. За время 20-летнего наблюдения частота развития всех больших и клинически значимых кровотечений составила 2,6/100 пациенто-лет, частота развития первого кровотечения – 5,86/100 пациенто-лет, тогда как частота повторных ГО – 7,06/100 пациенто-лет. Больные с высоким тромбоэмболическим риском должны получать антикоагулянты при условии тщательной коррекции модифицируемых факторов риска кровотечений.
Ключевые слова: фибрилляция предсердий, антикоагулянтная терапия, варфарин, прямые оральные антикоагулянты, геморрагические осложнения, рецидивирующие кровотечения.
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Materials and methods. In cohort study of patients with high-risk AF with absolute indications for ACT we enrolled 290 AF patients (130 women and 160 men) aged 32 to 85 years (the average age was 65.18±8.89 years). During the follow-up period, 92 patients developed hemorrhagic complications, and 73 of them resumed ACT. 35 of the 73 patients who resumed ACT developed a relapse of major/clinically significant bleeding.
Results. The frequency of resuming ACT after the first hemorrhagic complication increased over time from 75% in the period from 1999–2003 to 90% in the period 2015–2019. We were not able to establish an exact relationship between the presence of concomitant pathology and the decision to resume the ACT after bleeding. The only reliable reason for refusing to resume the ACT was the patient's categorical reluctance. Among patients who had recurrent hemorrhagic complications, the total score on the Charleson comorbidity scale was significantly higher (4.23±2.01 vs 3.52±1.43; p=0.0425). Patients with recurrent bleeding were significantly more likely to suffer from CKD with a decrease in GFR less than 60 ml/min/1.73 sq. m, and also had a history of erosive and ulcerative lesions of the gastrointestinal tract. There was also a significant Association of recurrent bleeding with the use of proton pump inhibitors. Subgroups of patients who switched from warfarin to taking direct oral anticoagulants after the first bleeding and subsequent recurrent bleeding did not differ in basic clinical characteristics from patients without bleeding after changing the anticoagulant. According to multiple regression analysis, NSAIDs showed a tendency to develop a relapse of B/C bleeding on the background of direct oral anticoagulants in patients who underwent GO on the background of warfarin therapy (b=0.4524, p=0.0530).
Conclusion. During the 20-year follow-up, the frequency of all major and clinically significant bleeding was 2.6/100 patients-years, the frequency of first bleeding was 5.86/100 patients-years, while the frequency of repeated hemorrhagic complications was 7.06/100 patients-years. Patients with a high thromboembolic risk should receive anticoagulants, provided that the modifiable risk factors for bleeding are carefully corrected.
Keywords: atrial fibrillation, anticoagulant therapy, warfarin, direct oral anticoagulants, hemorrhagic complications, recurrent bleeding.
Список литературы
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2. Kakkar AK, Mueller I, Bassand JP, et al. International longitudinal registry of patients with atrial fibrillation at risk of stroke: Global Anticoagulant Registry in the FIELD (GARFIELD). AHJ. 2012;163(1):13-9. doi: 10.1016/j.ahj.2011.09.011
3. Ruff CT, Giugliano RP, Braunwald E, et al. Comparison of the efficacy and safety of new oral anticoagulants with warfarin in patients with atrial fibrillation: a meta-analysis of randomised trials. Lancet. 2014;383:955-62. doi: 10.1016/S0140-6736(13)62343-0
4. Beyer-Westendorf J, Förster K, Pannach S, et al. Rates, management, and outcome of rivaroxaban bleeding in daily care: results from the Dresden NOAC registry. Blood. 2014;124:955-62. doi: 10.1182/blood-2014-03-563577
5. Management of major bleeding and outcomes in patients treated with direct oral anticoagulants: results from the START-Event registry. Int Emerg Med. 2018;13:1051-8. doi: 10.1007/s11739-018-1877-z
6. Lip G, et al. Risks of thromboembolism and bleeding with thromboprophylaxis in patients with atrial fibrillation: A net clinical benefit analysis using a "real world" nationwide cohort study. Thromb Haemost. 2011. doi: 10.1160/TH11-05-0364
7. Little D, Chai-Adisaksopha C, Hillis C, et al. Resumption of anticoagulant therapy after anticoagulant-related gastrointestinal bleeding: A systematic review and meta-analysis. Thromb Res. 2019;175:102-9. doi: 10.1016/j.thromres.2019.01.020
8. Cameron C, Coyle D, Richter T, et al. Systematic review and network meta-analysis comparing antithrombotic agents for the prevention of stroke and major bleeding in patients with atrial fibrillation. BMJ Open. 2014;4(6):e004301. doi: 10.1136/bmjopen-2013-004301
9. Pasquini M, Charidimou A, van Asch CJ, et al. Variation in Restarting Antithrombotic Drugs at Hospital Discharge After Intracerebral Hemorrhage. Stroke. 2014;45(9):2643-8. doi: 10.1161/strokeaha.114.006202
10. Kyohei M, Takatsugu Y, Hitoshi A, et al. Difference between the Upper and the Lower Gastrointestinal Bleeding in Patients Taking Nonvitamin K Oral Anticoagulants. BioMed Res Int. 2018;24:1-5. doi: 10.1155/2018/7123607
11. Zemlyanskaya ОА, Kropacheva ES, Dobrovolsky AB, Panchenko EP. Renal function in patients taking long-term warfarin (5-year prospective follow-up). Therapeutic Archive. 2017;89(9):78-86 (In Russ.) doi: 10.17116/terarkh201789978-86
12. Sciascia S, Radin M, Schreiber K, et al. Chronic kidney disease and anticoagulation: from vitamin K antagonists and heparins to direct oral anticoagulant agents. Int Emerg Med. 2017;12(8):1101-8. doi: 10.1007/s11739-017-1753-2
13. O'Brien EC, Simon DN, Thomas LE, et al. The ORBIT bleeding score: a simple bedside score to assess bleedingrisk in atrial fibrillation. Eur Heart J. 2015;36(46):3258-64. doi: 10.1093/eurheartj/ehv476
14. Kumar S, Lim E, Covic A, et al. Anticoagulation in Concomitant Chronic Kidney Disease and Atrial Fibrillation: JACC Review Topic of the Week. J Am Coll Cardiol. 2019;74(17):2204-15. doi: 10.1016/j.jacc.2019.08.1031
15. Kropacheva ES, Zemlyanskaya ОА, Panchenko EP. Long-term therapy safety warfarine: bleeding rate and clinical predictors of their development. Aterotromboz. 2017;1 (In Russ.) doi: 10.21518/2307-1109-2017-1-28-32
16. Al-Shahi Salman R, Dennis M, Sandercock P, et al. Effects of antiplatelet therapy after stroke due to intracerebral haemorrhage (RESTART): a randomised, open-label trial. Lancet. 2019;393(10191):2613-23. doi: 10.1016/S0140-6736(19)30840-2
17. Schjerning Olsen AM, McGettigan P, Gerds TA, et al. Risk of gastrointestinal bleeding associated with oral anticoagulation and non-steroidal anti-inflammatory drugs in patients with atrial fibrillation: a nationwide study. Eur Heart J Cardiovasc Pharmacother. 2019. pii: pvz069. doi: 10.1093/ehjcvp/pvz069
18. Dalgaard F, Mulder H, Wojdyla DM, et al. Patients With Atrial Fibrillation Taking Nonsteroidal Anti-Inflammatory Drugs and Oral Anticoagulants in the ARISTOTLE Trial. Circulation. 2020;141(1):10-20. doi: 10.1161/CIRCULATIONAHA.119.041296
19. Lip GY, Frison L, Halperin JL, Lane DA. Comparative validation of a novel risk score for predicting bleeding risk in anticoagulated patients with atrial fibrillation: the HAS-BLED (Hypertension, Abnormal Renal/Liver Function, Stroke, Bleeding History or Predisposition, Labile INR, Elderly, Drugs/Alcohol Concomitantly) score. J Am Coll Cardiol. 2011;57(2):173-80. doi: 10.1016/j.jacc. 2010.09.024
20. Fang MC, Go AS, Chang Y, et al. A new risk scheme to predict warfarin-associated hemorrhage: The ATRIA (Anticoagulation and Risk Factors in Atrial Fibrillation) Study. J Am Coll Cardiol. 2011;58(4):395-401. doi: 10.1016/j.jacc.2011.03.031
21. Gage BF, Yan Y, Milligan PE et al. Clinical classification schemes for predicting hemorrhage:results from the National Registry of Atrial Fibrillation (NRAF). Am Heart J. 2006;151(3):713-9. doi: 10.1016/j.ahj.2005.04.017
22. Olesen JB, Lip GY, Hansen PR, et al. Bleeding risk in 'real world' patients with atrial fibrillation: comparison of two establishedbleeding prediction schemes in a nationwide cohort. J Thromb Haemost. 2011;9(8):1460-7. doi: 10.1111/j.1538-7836.2011.04378.x
23. Hijazi Z, Oldgren J, Lindbäck J, et al. The novel biomarker-based ABC (age, biomarkers, clinical history)-bleeding risk score for patients with atrial fibrillation: a derivation and validation study. Lancet. 2016;387(10035):2302-11. doi: 10.1016/s0140-6736(16)00741-8
24. Berg DD, Ruff CT, Jarolim P, et al. Performance of the ABC Scores for Assessing the Risk of Stroke or Systemic Embolism and Bleeding in Patients With Atrial Fibrillation in ENGAGE AF-TIMI 48. Circulation. 2019;139(6):760-71. doi: 10.1161/CIRCULATIONAHA.118.038312
25. Hijazi Z, Oldgren J, Siegbahn A, et al Biomarkers in atrial fi brillation: a clinical review. Eur Heart J. 2013;34:1475-80. doi: 10.1093/eurheartj/eht024
26. Aulin J, Siegbahn A, Hijazi Z, et al. Interleukin-6 and C-reactive protein and risk for death and cardiovascular events in patients with atrial fibrillation. Am Heart J. 2015;170:1151-60. doi: 10.1016/j.ahj.2015.09.018
27. Christersson C, Wallentin L, Andersson U, et al. D-dimer and risk of thromboembolic and bleeding events in patients with atrial fibrillation – observations from the ARISTOTLE trial. J Thromb Haemost. 2014;12:1401-12. doi: 10.1111/jth.12638
28. Hijazi Z, Aulin J, Andersson U, et al. Biomarkers of inflammation and risk of cardiovascular events in anticoagulated patients with atrial fibrillation. Heart. 2016;102:508-17. doi: 10.1136/heartjnl-2015-308887
29. Wallentin L, Hijazi Z, Andersson U, et al. Growth differentiation factor 15, a marker of oxidative stress and inflammation, for risk assessment in patients with atrial fibrillation: insights from the Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation (ARISTOTLE) trial. Circulation. 2014;130(21):1847-58. doi: 10.1161/CIRCULATIONAHA.114.011204
30. Esteve-Pastor MA, Rivera-Caravaca JM, Roldan V, et al. Long-term bleeding risk prediction in "real world" patients with atrial fibrillation: Comparison of the HAS-BLED and ABC-Bleeding risk scores. The Murcia Atrial Fibrillation Project. Thromb Haemost. 2017;117(10):1848-58. doi: 10.1160/TH17-07-0478
2. Kakkar AK, Mueller I, Bassand JP, et al. International longitudinal registry of patients with atrial fibrillation at risk of stroke: Global Anticoagulant Registry in the FIELD (GARFIELD). AHJ. 2012;163(1):13-9. doi: 10.1016/j.ahj.2011.09.011
3. Ruff CT, Giugliano RP, Braunwald E, et al. Comparison of the efficacy and safety of new oral anticoagulants with warfarin in patients with atrial fibrillation: a meta-analysis of randomised trials. Lancet. 2014;383:955-62. doi: 10.1016/S0140-6736(13)62343-0
4. Beyer-Westendorf J, Förster K, Pannach S, et al. Rates, management, and outcome of rivaroxaban bleeding in daily care: results from the Dresden NOAC registry. Blood. 2014;124:955-62. doi: 10.1182/blood-2014-03-563577
5. Management of major bleeding and outcomes in patients treated with direct oral anticoagulants: results from the START-Event registry. Int Emerg Med. 2018;13:1051-8. doi: 10.1007/s11739-018-1877-z
6. Lip G, et al. Risks of thromboembolism and bleeding with thromboprophylaxis in patients with atrial fibrillation: A net clinical benefit analysis using a "real world" nationwide cohort study. Thromb Haemost. 2011. doi: 10.1160/TH11-05-0364
7. Little D, Chai-Adisaksopha C, Hillis C, et al. Resumption of anticoagulant therapy after anticoagulant-related gastrointestinal bleeding: A systematic review and meta-analysis. Thromb Res. 2019;175:102-9. doi: 10.1016/j.thromres.2019.01.020
8. Cameron C, Coyle D, Richter T, et al. Systematic review and network meta-analysis comparing antithrombotic agents for the prevention of stroke and major bleeding in patients with atrial fibrillation. BMJ Open. 2014;4(6):e004301. doi: 10.1136/bmjopen-2013-004301
9. Pasquini M, Charidimou A, van Asch CJ, et al. Variation in Restarting Antithrombotic Drugs at Hospital Discharge After Intracerebral Hemorrhage. Stroke. 2014;45(9):2643-8. doi: 10.1161/strokeaha.114.006202
10. Kyohei M, Takatsugu Y, Hitoshi A, et al. Difference between the Upper and the Lower Gastrointestinal Bleeding in Patients Taking Nonvitamin K Oral Anticoagulants. BioMed Res Int. 2018;24:1-5. doi: 10.1155/2018/7123607
11. Землянская О.А., Кропачева Е.С., Добровольский А.Б., Панчен-
ко Е.П. Функция почек у больных, длительно принимающих варфарин (5-летнее проспективное наблюдение). Терапевтический архив. 2017;89(9):78-86 [Zemlyanskaya ОА, Kropacheva ES, Dobrovolsky AB, Panchenko EP. Renal function in patients taking long-term warfarin (5-year prospective follow-up). Therapeutic Archive. 2017;89(9):78-86 (In Russ.)]. doi: 10.17116/terarkh201789978-86
12. Sciascia S, Radin M, Schreiber K, et al. Chronic kidney disease and anticoagulation: from vitamin K antagonists and heparins to direct oral anticoagulant agents. Int Emerg Med. 2017;12(8):1101-8. doi: 10.1007/s11739-017-1753-2
13. O'Brien EC, Simon DN, Thomas LE, et al. The ORBIT bleeding score: a simple bedside score to assess bleedingrisk in atrial fibrillation. Eur Heart J. 2015;36(46):3258-64. doi: 10.1093/eurheartj/ehv476
14. Kumar S, Lim E, Covic A, et al. Anticoagulation in Concomitant Chronic Kidney Disease and Atrial Fibrillation: JACC Review Topic of the Week. J Am Coll Cardiol. 2019;74(17):2204-15. doi: 10.1016/j.jacc.2019.08.1031
15. Кропачева Е.С., Землянская О.А., Панченко Е.П. и др. Безопасность длительной терапии варфарином: частота кровотечений и клинические предикторы их развития (результаты проспективного 15-летнего наблюдения). Атеротромбоз. 2017;1 [Kropacheva ES, Zemlyanskaya ОА, Panchenko EP. Long-term therapy safety warfarine: bleeding rate and clinical predictors of their development. Aterotromboz. 2017;1 (In Russ.)]. doi: 10.21518/2307-1109-2017-1-28-32
16. Al-Shahi Salman R, Dennis M, Sandercock P, et al. Effects of antiplatelet therapy after stroke due to intracerebral haemorrhage (RESTART): a randomised, open-label trial. Lancet. 2019;393(10191):2613-23. doi: 10.1016/S0140-6736(19)30840-2
17. Schjerning Olsen AM, McGettigan P, Gerds TA, et al. Risk of gastrointestinal bleeding associated with oral anticoagulation and non-steroidal anti-inflammatory drugs in patients with atrial fibrillation: a nationwide study. Eur Heart J Cardiovasc Pharmacother. 2019. pii: pvz069. doi: 10.1093/ehjcvp/pvz069
18. Dalgaard F, Mulder H, Wojdyla DM, et al. Patients With Atrial Fibrillation Taking Nonsteroidal Anti-Inflammatory Drugs and Oral Anticoagulants in the ARISTOTLE Trial. Circulation. 2020;141(1):10-20. doi: 10.1161/CIRCULATIONAHA.119.041296
19. Lip GY, Frison L, Halperin JL, Lane DA. Comparative validation of a novel risk score for predicting bleeding risk in anticoagulated patients with atrial fibrillation: the HAS-BLED (Hypertension, Abnormal Renal/Liver Function, Stroke, Bleeding History or Predisposition, Labile INR, Elderly, Drugs/Alcohol Concomitantly) score. J Am Coll Cardiol. 2011;57(2):173-80. doi: 10.1016/j.jacc. 2010.09.024
20. Fang MC, Go AS, Chang Y, et al. A new risk scheme to predict warfarin-associated hemorrhage: The ATRIA (Anticoagulation and Risk Factors in Atrial Fibrillation) Study. J Am Coll Cardiol. 2011;58(4):395-401. doi: 10.1016/j.jacc.2011.03.031
21. Gage BF, Yan Y, Milligan PE et al. Clinical classification schemes for predicting hemorrhage:results from the National Registry of Atrial Fibrillation (NRAF). Am Heart J. 2006;151(3):713-9. doi: 10.1016/j.ahj.2005.04.017
22. Olesen JB, Lip GY, Hansen PR, et al. Bleeding risk in 'real world' patients with atrial fibrillation: comparison of two establishedbleeding prediction schemes in a nationwide cohort. J Thromb Haemost. 2011;9(8):1460-7. doi: 10.1111/j.1538-7836.2011.04378.x
23. Hijazi Z, Oldgren J, Lindbäck J, et al. The novel biomarker-based ABC (age, biomarkers, clinical history)-bleeding risk score for patients with atrial fibrillation: a derivation and validation study. Lancet. 2016;387(10035):2302-11. doi: 10.1016/s0140-6736(16)00741-8
24. Berg DD, Ruff CT, Jarolim P, et al. Performance of the ABC Scores for Assessing the Risk of Stroke or Systemic Embolism and Bleeding in Patients With Atrial Fibrillation in ENGAGE AF-TIMI 48. Circulation. 2019;139(6):760-71. doi: 10.1161/CIRCULATIONAHA.118.038312
25. Hijazi Z, Oldgren J, Siegbahn A, et al Biomarkers in atrial fi brillation: a clinical review. Eur Heart J. 2013;34:1475-80. doi: 10.1093/eurheartj/eht024
26. Aulin J, Siegbahn A, Hijazi Z, et al. Interleukin-6 and C-reactive protein and risk for death and cardiovascular events in patients with atrial fibrillation. Am Heart J. 2015;170:1151-60. doi: 10.1016/j.ahj.2015.09.018
27. Christersson C, Wallentin L, Andersson U, et al. D-dimer and risk of thromboembolic and bleeding events in patients with atrial fibrillation – observations from the ARISTOTLE trial. J Thromb Haemost. 2014;12:1401-12. doi: 10.1111/jth.12638
28. Hijazi Z, Aulin J, Andersson U, et al. Biomarkers of inflammation and risk of cardiovascular events in anticoagulated patients with atrial fibrillation. Heart. 2016;102:508-17. doi: 10.1136/heartjnl-2015-308887
29. Wallentin L, Hijazi Z, Andersson U, et al. Growth differentiation factor 15, a marker of oxidative stress and inflammation, for risk assessment in patients with atrial fibrillation: insights from the Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation (ARISTOTLE) trial. Circulation. 2014;130(21):1847-58. doi: 10.1161/CIRCULATIONAHA.114.011204
30. Esteve-Pastor MA, Rivera-Caravaca JM, Roldan V, et al. Long-term bleeding risk prediction in "real world" patients with atrial fibrillation: Comparison of the HAS-BLED and ABC-Bleeding risk scores. The Murcia Atrial Fibrillation Project. Thromb Haemost. 2017;117(10):1848-58. doi: 10.1160/TH17-07-0478
________________________________________________
2. Kakkar AK, Mueller I, Bassand JP, et al. International longitudinal registry of patients with atrial fibrillation at risk of stroke: Global Anticoagulant Registry in the FIELD (GARFIELD). AHJ. 2012;163(1):13-9. doi: 10.1016/j.ahj.2011.09.011
3. Ruff CT, Giugliano RP, Braunwald E, et al. Comparison of the efficacy and safety of new oral anticoagulants with warfarin in patients with atrial fibrillation: a meta-analysis of randomised trials. Lancet. 2014;383:955-62. doi: 10.1016/S0140-6736(13)62343-0
4. Beyer-Westendorf J, Förster K, Pannach S, et al. Rates, management, and outcome of rivaroxaban bleeding in daily care: results from the Dresden NOAC registry. Blood. 2014;124:955-62. doi: 10.1182/blood-2014-03-563577
5. Management of major bleeding and outcomes in patients treated with direct oral anticoagulants: results from the START-Event registry. Int Emerg Med. 2018;13:1051-8. doi: 10.1007/s11739-018-1877-z
6. Lip G, et al. Risks of thromboembolism and bleeding with thromboprophylaxis in patients with atrial fibrillation: A net clinical benefit analysis using a "real world" nationwide cohort study. Thromb Haemost. 2011. doi: 10.1160/TH11-05-0364
7. Little D, Chai-Adisaksopha C, Hillis C, et al. Resumption of anticoagulant therapy after anticoagulant-related gastrointestinal bleeding: A systematic review and meta-analysis. Thromb Res. 2019;175:102-9. doi: 10.1016/j.thromres.2019.01.020
8. Cameron C, Coyle D, Richter T, et al. Systematic review and network meta-analysis comparing antithrombotic agents for the prevention of stroke and major bleeding in patients with atrial fibrillation. BMJ Open. 2014;4(6):e004301. doi: 10.1136/bmjopen-2013-004301
9. Pasquini M, Charidimou A, van Asch CJ, et al. Variation in Restarting Antithrombotic Drugs at Hospital Discharge After Intracerebral Hemorrhage. Stroke. 2014;45(9):2643-8. doi: 10.1161/strokeaha.114.006202
10. Kyohei M, Takatsugu Y, Hitoshi A, et al. Difference between the Upper and the Lower Gastrointestinal Bleeding in Patients Taking Nonvitamin K Oral Anticoagulants. BioMed Res Int. 2018;24:1-5. doi: 10.1155/2018/7123607
11. Zemlyanskaya ОА, Kropacheva ES, Dobrovolsky AB, Panchenko EP. Renal function in patients taking long-term warfarin (5-year prospective follow-up). Therapeutic Archive. 2017;89(9):78-86 (In Russ.) doi: 10.17116/terarkh201789978-86
12. Sciascia S, Radin M, Schreiber K, et al. Chronic kidney disease and anticoagulation: from vitamin K antagonists and heparins to direct oral anticoagulant agents. Int Emerg Med. 2017;12(8):1101-8. doi: 10.1007/s11739-017-1753-2
13. O'Brien EC, Simon DN, Thomas LE, et al. The ORBIT bleeding score: a simple bedside score to assess bleedingrisk in atrial fibrillation. Eur Heart J. 2015;36(46):3258-64. doi: 10.1093/eurheartj/ehv476
14. Kumar S, Lim E, Covic A, et al. Anticoagulation in Concomitant Chronic Kidney Disease and Atrial Fibrillation: JACC Review Topic of the Week. J Am Coll Cardiol. 2019;74(17):2204-15. doi: 10.1016/j.jacc.2019.08.1031
15. Kropacheva ES, Zemlyanskaya ОА, Panchenko EP. Long-term therapy safety warfarine: bleeding rate and clinical predictors of their development. Aterotromboz. 2017;1 (In Russ.) doi: 10.21518/2307-1109-2017-1-28-32
16. Al-Shahi Salman R, Dennis M, Sandercock P, et al. Effects of antiplatelet therapy after stroke due to intracerebral haemorrhage (RESTART): a randomised, open-label trial. Lancet. 2019;393(10191):2613-23. doi: 10.1016/S0140-6736(19)30840-2
17. Schjerning Olsen AM, McGettigan P, Gerds TA, et al. Risk of gastrointestinal bleeding associated with oral anticoagulation and non-steroidal anti-inflammatory drugs in patients with atrial fibrillation: a nationwide study. Eur Heart J Cardiovasc Pharmacother. 2019. pii: pvz069. doi: 10.1093/ehjcvp/pvz069
18. Dalgaard F, Mulder H, Wojdyla DM, et al. Patients With Atrial Fibrillation Taking Nonsteroidal Anti-Inflammatory Drugs and Oral Anticoagulants in the ARISTOTLE Trial. Circulation. 2020;141(1):10-20. doi: 10.1161/CIRCULATIONAHA.119.041296
19. Lip GY, Frison L, Halperin JL, Lane DA. Comparative validation of a novel risk score for predicting bleeding risk in anticoagulated patients with atrial fibrillation: the HAS-BLED (Hypertension, Abnormal Renal/Liver Function, Stroke, Bleeding History or Predisposition, Labile INR, Elderly, Drugs/Alcohol Concomitantly) score. J Am Coll Cardiol. 2011;57(2):173-80. doi: 10.1016/j.jacc. 2010.09.024
20. Fang MC, Go AS, Chang Y, et al. A new risk scheme to predict warfarin-associated hemorrhage: The ATRIA (Anticoagulation and Risk Factors in Atrial Fibrillation) Study. J Am Coll Cardiol. 2011;58(4):395-401. doi: 10.1016/j.jacc.2011.03.031
21. Gage BF, Yan Y, Milligan PE et al. Clinical classification schemes for predicting hemorrhage:results from the National Registry of Atrial Fibrillation (NRAF). Am Heart J. 2006;151(3):713-9. doi: 10.1016/j.ahj.2005.04.017
22. Olesen JB, Lip GY, Hansen PR, et al. Bleeding risk in 'real world' patients with atrial fibrillation: comparison of two establishedbleeding prediction schemes in a nationwide cohort. J Thromb Haemost. 2011;9(8):1460-7. doi: 10.1111/j.1538-7836.2011.04378.x
23. Hijazi Z, Oldgren J, Lindbäck J, et al. The novel biomarker-based ABC (age, biomarkers, clinical history)-bleeding risk score for patients with atrial fibrillation: a derivation and validation study. Lancet. 2016;387(10035):2302-11. doi: 10.1016/s0140-6736(16)00741-8
24. Berg DD, Ruff CT, Jarolim P, et al. Performance of the ABC Scores for Assessing the Risk of Stroke or Systemic Embolism and Bleeding in Patients With Atrial Fibrillation in ENGAGE AF-TIMI 48. Circulation. 2019;139(6):760-71. doi: 10.1161/CIRCULATIONAHA.118.038312
25. Hijazi Z, Oldgren J, Siegbahn A, et al Biomarkers in atrial fi brillation: a clinical review. Eur Heart J. 2013;34:1475-80. doi: 10.1093/eurheartj/eht024
26. Aulin J, Siegbahn A, Hijazi Z, et al. Interleukin-6 and C-reactive protein and risk for death and cardiovascular events in patients with atrial fibrillation. Am Heart J. 2015;170:1151-60. doi: 10.1016/j.ahj.2015.09.018
27. Christersson C, Wallentin L, Andersson U, et al. D-dimer and risk of thromboembolic and bleeding events in patients with atrial fibrillation – observations from the ARISTOTLE trial. J Thromb Haemost. 2014;12:1401-12. doi: 10.1111/jth.12638
28. Hijazi Z, Aulin J, Andersson U, et al. Biomarkers of inflammation and risk of cardiovascular events in anticoagulated patients with atrial fibrillation. Heart. 2016;102:508-17. doi: 10.1136/heartjnl-2015-308887
29. Wallentin L, Hijazi Z, Andersson U, et al. Growth differentiation factor 15, a marker of oxidative stress and inflammation, for risk assessment in patients with atrial fibrillation: insights from the Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation (ARISTOTLE) trial. Circulation. 2014;130(21):1847-58. doi: 10.1161/CIRCULATIONAHA.114.011204
30. Esteve-Pastor MA, Rivera-Caravaca JM, Roldan V, et al. Long-term bleeding risk prediction in "real world" patients with atrial fibrillation: Comparison of the HAS-BLED and ABC-Bleeding risk scores. The Murcia Atrial Fibrillation Project. Thromb Haemost. 2017;117(10):1848-58. doi: 10.1160/TH17-07-0478
Авторы
А.И. Миронова (Староверова), Е.П. Панченко, Е.С. Кропачева, О.А. Землянская
Институт клинической кардиологии им. А.Л. Мясникова ФГБУ «Национальный медицинский исследовательский центр кардиологии» Минздрава России, Москва, Россия
Myasnikov Institute of Clinical Cardiology, National Medical Research Center for Cardiology, Moscow, Russia
Институт клинической кардиологии им. А.Л. Мясникова ФГБУ «Национальный медицинский исследовательский центр кардиологии» Минздрава России, Москва, Россия
________________________________________________
Myasnikov Institute of Clinical Cardiology, National Medical Research Center for Cardiology, Moscow, Russia
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