ANTITHROMBOTIC THERAPY IN ELDERLY AND SENILE PERSONS WITH ATRIAL FIBRILLATION

Abstract

Old age is the most important and independent risk factor for atrial fibrillation (AF). According to the report of the World Health Organization, life expectancy is growing rapidly all over the world. Thus, in the Russian Federation, as of 2015, the proportion of people over 60 years old was 20-24 %, while by 2050 an increase to 25-29 % is predicted. In the elderly and senile age, there is a high risk of atrial fibrillation (AF). The proportion of patients with AF at the age of 65-85 years reaches 70 %, and the average age of patients with AF is 75 years. When deciding on the appointment of antithrombotic therapy for an elderly patient with AF, it is necessary to assess the risk of developing stroke without treatment and the risk of developing bleeding, especially intracranial, during treatment. In addition, elderly patients suffer from many comorbidities. The article uses the HAS-BLED and CHA2DS2-VAS scales used to assess the risk of thromboembolic and hemorrhagic complications and approaches to antithrombotic therapy in elderly and old people during inpatient treatment of the Geriatric Center of the Republican Hospital № 3. Low anticoagulant therapy was noted at the outpatient stage - 42.6 %, 47.8 % of patients were on disaggregant therapy (aspirin). During hospitalization, new oral anticoagulants of direct action were prescribed and recommended at discharge in 56.6 % of cases, warfarin in 23.6 % of cases. Aspirin is replaced with new oral anticoagulants of direct action in 38 % of cases.