Open AccessRenal Function Protection as an Important Component of a Comprehensive Approach to the Management of Patients with Atrial Fibrillation
Author(s) -
Т. В. Павлова
Publication year - 2022
Publication title -
racionalʹnaâ farmakoterapiâ v kardiologii
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.161
H-Index - 9
eISSN - 2225-3653
pISSN - 1819-6446
DOI - 10.20996/1819-6446-2021-12-08
Subject(s) - medicine , rivaroxaban , atrial fibrillation , kidney disease , intensive care medicine , population , polypharmacy , warfarin , myocardial infarction , cardiology , stroke (engine) , mechanical engineering , environmental health , engineering
The increase in the life expectancy of the population is accompanied by an increase in the prevalence of diseases for which old and senile age are risk factors. Atrial fibrillation (AF) and chronic kidney disease (CKD) are two diseases that can coexist in a patient. The risk of ac thromboembolic and hemorrhagic events in this case increases due to the mutual aggravating influence of these diseases. In addition, these patients have a high incidence of coronary events, and cardiovascular complications are the main cause of death in patients with AF and CKD. Consequently, such patients require an integrated approach to treatment, and their management is a complex clinical task. The direct oral anticoagulant rivaroxaban has been most studied in a population of comorbid AF and CKD patients and has proven a high efficacy and safety profile in these patients in randomized controlled trials. In addition, rivaroxaban has shown a significant reduction in the risk of myocardial infarction in various patients, as well as the possibility of preserving renal function to a greater extent compared with warfarin therapy, and a possible positive effect on reducing the risk of cognitive impairment. A single dosing regimen can improve adherence to treatment, which is one of the key conditions for achieving the above effects. Thus, these factors make it possible to achieve comprehensive protection of comorbid patients with AF and CKD.