Patient with myocardial infarction, atrial fibrillation and high risk for hemorrhage: reasonable choice of anticoagulant for effective prevention of ischemic events

Author:

Pecherina T. B.1,Zlydneva V. O.2,Kashtalap V. V.3,Barbarash O. L.3

Affiliation:

1. Federal State Budgetary Scientific Institution Research Institute for Complex Issues of Cardiovascular Diseases; State Budgetary Healthcare Institution of the Kemerovo Region Kemerovo Regional Clinical Cardiology Dispensary named after academician L.S. Barbarash

2. Federal State Budgetary Scientific Institution Research Institute for Complex Issues of Cardiovascular Diseases

3. Federal State Budgetary Scientific Institution Research Institute for Complex Issues of Cardiovascular Diseases; State Budgetary Educational Institution of Higher Education “Kemerovo State Medical University” of the Ministry of Healthcare of the Russian Federation

Abstract

Current clinical practice faces the challenges in selecting optimal drugs and the duration of antithrombotic treatment in patients with acute coronary syndrome with atrial fibrillation. A continuous increase of using non-vitamin K oral anticoagulants (NOAC), dabigatran, rivaroxaban, apixaban, edoxaban, and novel antiplatelet agents, prasugrel and ticagrelor, has complicated the decision-making process in this group of patients. The presented clinical case reports the use of dabigatran as a part of double antithrombotic therapy in an elderly patient with type 2 myocardial infarction, paroxysmal AF and a high risk for hemorrhage. The drug choice and its dosage were chosen using the personalized risk assessment. The presented approach has been early proved by the results of the recent randomized clinical trials and, therefore, may be translated into routine clinical practice.

Publisher

NII KPSSZ

Subject

Cardiology and Cardiovascular Medicine,Critical Care and Intensive Care Medicine,Rehabilitation,Emergency Medicine,Surgery

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