evrazkarЕвразийский Кардиологический ЖурналEurasian heart journal2225-16852305-0748Евразийская ассоциация кардиологов10.38109/2225-1685-2017-4-122-132evrazkar-265Research ArticleОБЗОРREVIEWПРОБЛЕМНЫЕ АСПЕКТЫ ПРИМЕНЕНИЯ ОРАЛЬНЫХ АНТИКОАГУЛЯНТОВ У ПАЦИЕНТОВ С ЛЕГОЧНОЙ АРТЕРИАЛЬНОЙ ГИПЕРТЕНЗИЕЙ РАЗЛИЧНОГО ГЕНЕЗАORAL ANTICOAGULANTS IN PATIENTS WITH DIFFERENT FORMS OF PULMONARY ARTERIAL HYPERTENSION, ASPECTS OF THE PROBLEMГрацианскаяС. Е.GratsianskayaS. Ye.

Ординатор отдела легочной гипертензии и заболеваний сердца

8-495-414-68- 42

121552, г. Москва, ул. 3-я Черепковская, д. 15 а

Medical resident of the department of pulmonary hypertension and heart disease

8-495-414-68-42

svetik_lap@mail.ruМартынюкТ. В.MartynyukT. V.

Руководитель отдела легочной гипертензии и заболеваний сердца, д.м.н.;

8-495-414-64-50;

121552, г. Москва, ул. 3-я Черепковская, д. 15 а

MD, leading researcher, head of the department of pulmonary hypertension and heart disease

121552, Moscow, 3rd Street Cherepkovskaya, Building 15a,

8-495-414-64-50

trukhiniv@mail.ruНаконечниковС. Н.NakonechnikovS. N.

Заместитель генерального директора, д.м.н. профессор

8-495-414- 61-18

121552, г. Москва, ул. 3-я Черепковская, д. 15 а

Deputy director general 

121552, Moscow, 3rd Street Cherepkovskaya, Building 15a

8-495-414-61-18

snn_cardio@mail.ruЧазоваИ. Е.ChazovaI. Ye.

Директор, руководитель отдела гипертонии, акад. РАН, профессор, д.м.н.

8-495-415-52- 05

121552, г. Москва, ул. 3-я Черепковская, д. 15 а

Academician of Russian Academy of Sciences, Professor, MD, Director, Head of Department 

121552, Moscow, 3rd Street Cherepkovskaya, Building 15a

8-495-415-52-05

c34h@yandex.ruФГБУ «Национальный медицинский исследовательский центр кардиологии» Минздрава РоссииРоссияNational Medical Research Centre of cardiology of Ministry of HealthRussian FederationФГБУ «Национальный медицинский исследовательский центр кардиологии» Минздрава РоссииРоссияNational Medical Research Center for Cardiology of the Ministry of HealthRussian Federation20173012201704122132Copyright © Грацианская С.Е., Мартынюк Т.В., Наконечников С.Н., Чазова И.Е., 20172017Грацианская С.Е., Мартынюк Т.В., Наконечников С.Н., Чазова И.Е.Gratsianskaya S.Y., Martynyuk T.V., Nakonechnikov S.N., Chazova I.Y.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.heartj.asia/jour/article/view/265

Использование пероральных антикоагулянтов у больных с легочной артериальной гипертензией (ЛАГ) остаётся спорным вопросом на протяжении десятилетия. Несмотря на отсутствие убедительных доказательств, современные рекомендации предлагают использование антикоагулянтов у больных с идиопатической легочной гипертензией (ИЛГ), но в то же время представляют неоднозначную рекомендацию для других форм ЛАГ. В настоящем обзоре рассмотрены современные возможности и проблемные аспекты пероральной антикоагулянтной терапии при ЛАГ различной этиологии, влияние на течение заболевания и прогноз.

The use of direct oral anticoagulants in patients with pulmonary arterial hypertension (PAH) has remained a controversial issue for a decade. Despite the lack of solid evidence from well-controlled prospective trials, anticoagulation has been recommended for patients with idiopathic pulmonary arterial hypertension (IPAH), but it is unclear whether this recommendation should be extrapolated to patients with other forms of PAH. In this review, we discuss the current opportunities and problematic aspects of oral anticoagulation therapy in different forms of PAH, the influence on disease course and prognosis..

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Effect of warfarin treatment on survival of patients with pulmonary arterial hypertension (PAH) in the Registry to Evaluate Early and LongTerm PAH Disease Management (REVEAL) // Circulation. – 2015. – Vol. 132. – P. 2403–11.Preston I.R., Roberts K.E., Miller D.P., et al. Effect of warfarin treatment on survival of patients with pulmonary arterial hypertension (PAH) in the Registry to Evaluate Early and LongTerm PAH Disease Management (REVEAL) // Circulation. – 2015. – Vol. 132. – P. 2403–11.Calderone A., Stevens W., Prior D., et al. Multicentre randomised placebo-controlled trial of oral anticoagulation with apixaban in systemic sclerosis-related pulmonary arterial hypertension: the SPHInX study protocol // BMJ Open. – 2016. – Vol. 6. - e011028.Calderone A., Stevens W., Prior D., et al. 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The authors declare that there are no conflicts of interest present.