Atrial Fibrillation and Diabetes Mellitus: the Control of Thromboembolic Risk
| Autor: | N V Kulikov, A G Obrezan |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Administration Oral 030204 cardiovascular system & hematology 03 medical and health sciences 0302 clinical medicine Rivaroxaban Risk Factors Diabetes mellitus Internal medicine Atrial Fibrillation Diabetes Mellitus Humans Medicine Glucose homeostasis 030212 general & internal medicine Stroke business.industry Warfarin Anticoagulants Atrial fibrillation medicine.disease Heart failure Cardiology Cardiology and Cardiovascular Medicine business Kidney disease medicine.drug |
| Zdroj: | Kardiologiia. 60:108-114 |
| ISSN: | 2412-5660 0022-9040 |
| Popis: | Atrial fibrillation is one of the most common concomitant diseases in patients with diabetes mellitus (DM). Meta-analyses of multiple studies have shown that the risk of AF is higher for diabetic patients with impaired glucose homeostasis than for patients without DM. Patients with AF and DM were younger, more frequently had arterial hypertension, chronic kidney disease, heart failure, and ischemic heart disease, and stroke and were characterized with a more severe course of AF. The article discusses possible mechanisms of the mutually aggravating effects of DM and AF, scales for evaluating the risk of bleeding (CHADS2, CHA2DS2‑VASc, HAS-BLED), and the role of anticoagulants. A meta-analysis of 16 randomized clinical studies, including 9 874 patients, has demonstrated the efficacy of oral anticoagulants in prevention of stroke with an overall decrease in the relative risk by 62 % compared to placebo (95% confidence interval, from 48 to 72 ). For prevention of complications in patients with AF and DM, current antithrombotic therapies can be used, specifically the oral factor Xa inhibitor, rivaroxaban, which is the best studied in patients with AF and DM and represents a possible alternative to warfarin in such patients. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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