evrazkarЕвразийский Кардиологический ЖурналEurasian heart journal2225-16852305-0748Евразийская ассоциация кардиологов10.38109/2225-1685-2014-1-90-94evrazkar-5561Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИORIGINAL PAPERSПРОГНОЗИРОВАНИЕ РАЗВИТИЯ ТРОМБОЭМБОЛИЧЕСКИХ ОСЛОЖНЕНИЙ У БОЛЬНЫХ С ДЛИТЕЛЬНО СУЩЕСТВУЮЩИМИ ФОРМАМИ ФИБРИЛЛЯЦИИ ПРЕДСЕРДИЙPREDICTION OF THROMBOEMBOLISM IN PATIENTS WITH LONG-LASTING ATRIAL FIBRILLATIONКурбановРавшанбек ДавлетовичKurbanovR. D.noemail@neicon.ruЗакировНодир УзуевичZakirovN. J.noemail@neicon.ruИрисовДжамшид БаходировичIrisovD. B.doktoruz@mail.ruХусановШухрат СуннатовичKhusanovSh. S.noemail@neicon.ruРеспубликанский специализированный центр кардиологииРоссияRepublican Specialized Center of CardiologyRussian Federation201430032014019094Copyright © Курбанов Р.Д., Закиров Н.У., Ирисов Д.Б., Хусанов Ш.С., 20142014Курбанов Р.Д., Закиров Н.У., Ирисов Д.Б., Хусанов Ш.С.Kurbanov R.D., Zakirov N.J., Irisov D.B., Khusanov S.S.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/5561

Цель исследования. Сравнительный анализ оценки риска тромбоэмболических осложнений по шкалам CHADS2 и CHA2DS2-VASc, изучение профилактической эффективности различных антитромботических препаратов у больных с длительно существующей фибрилляцией предсердий (ФП) в течение 1 года наблюдения. Материал и методы. В исследование включено 108 больных в возрасте от 38 до 78 лет с постоянной или персистирующей ФП, средний возраст 62,6±8,4лет. У 93,5% пациентов диагностирована ИБС и/или ГБ, у 6,5% - некоронарогенная патология сердца. Риск тромбоэмболических осложнений (ТЭО) оценивался по шкалам CHADS2 и CHA2DS2-VASc. Результаты. Больные с низким риском развития ТЭО по шкале CHADS2 составили 2.8%, при их отсутствии по шкале CHA2DS2-VASc. Больные со средним риском развития ТЭО, определяемым согласно используемым шкалам, составили 63,9% и 7,4% (χ2 =72.653; р=0,000), соответственно, а с высоким риском - 33,3% и 92,6% (χ2 =78.796; р=0,000). В зависимости от путей профилактики ТЭО больные были разделены на 2 группы. В 1 группе больных, принимающих Варфарин (n=90), конечные точки наблюдались в 5,6% случаях. Во 2 группе (n=18), получавших ацетилсалициловую кислоту (АСК), конечные точки наблюдались у 27,8% больных. Заключение. Внедрение новой шкалы CHA2DS2-VASc привело к увеличению лиц, нуждающихся в обязательной антикоагулянтной терапии в 2,8 раза. В группе больных с ФП, получавших Варфарин, в сравнении с группой лиц, принимавших АСК, случаи ишемического инсульта (ИИ) развивались реже, а их клинические проявления менее выражены и характеризуются более благоприятным течением.

The aim of the study. Comparative analysis of the risk assessment of thromboembolism by CHADS2 and CHA2DS2-VASc scores, and to study the preventive effectiveness of different antithrombotic agents in patients with long-lasting аtrial fibrillation (AF) at 1 year follow-up. Materials and methods. The study included 108 patients aged 38 to 78 years old (mean age 62,6±8,4 years) with persistent or permanent AF. In 93.5% of patients revealed coronary artery disease and / or arterial hypertension, in 6.5% - non-coronary heart diseases. The risk of tromboembolism assessed by CHADS2 and CHA2DS2-VASc scores. Results. Patients at low risk of tromboembolism, according to CHADS2 score was 2.8%, in their absence, on a CHA2DS2-VASc score. Patients with moderate risk of tromboembolism, in these scores were 63.9% and 7,4% (χ2=72.653; p=0.000) respectively, and a high risk of tromboembolism - 33,3% and 92,6% (χ2=78,796, p=0.000) respectively. Depending on the ways to prevent tromboembolism, patients were divided into 2 groups. 1st group included patients treated with warfarin (n=90), and the endpoints were observed in 5.6% of patients. 2nd group included patients (n=18) treated with acetylsalicylic acid (ASA) and the end point was observed in 27.8% of patients. Conclusion. The introduction of a new CHA2DS2-VASc score led to an increase number of patients, who need mandatory anticoagulant therapy by 2.8 times. In the group of patients with atrial fibrillation treated with warfarin compared with a group of patients treated with aspirin, where cases of ischemic stroke have developed less often, and their clinical manifestation are less pronounced and are characterized by a benign course.

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The authors declare that there are no conflicts of interest present.