How to increase the safety of antithrombotic therapy in cardiology patients


DOI: https://dx.doi.org/10.18565/therapy.2024.2.172-180

Vorobyeva N.M., Malaya I.P., Zakiev V.D., Tkacheva O.N.

N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia – Russian Gerontological Research and Clinical Center, Moscow
Abstract. Gastrointestinal bleeding (GIB) is a serious complication of antithrombotic therapy. According to the data of Russian single-center prospective register of long-term antithrombotic therapy REGATA, a significant proportion of patients with stable coronary heart disease receiving antiplatelet agents and patients with atrial fibrillation using oral anticoagulants have concomitant pathologies of the gastrointestinal tract (GIT) and a high risk of GIB. At the same time, the frequency of prescribing gastroprotectors is insufficient for effective prevention of bleeding. Moreover, taking proton pump inhibitors (PPIs) alone did not fully reduce the risk of GIB arising. In accordance with the “Expert consensus on reducing the risk of gastrointestinal bleeding in patients receiving oral anticoagulants”, experts recommend prescribing PPIs in combination with rebamipide to protect the mucous membrane throughout all gastrointestinal tract. At the same time, unlike PPIs, the duration of use of which should be limited due to the risk of serious adverse events, rebamipide for the purpose of gastroprotection could be used indefinitely.

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About the Autors


Natalya M. Vorobyeva, MD, Dr. Sci. (Medicine), senior researcher at the Department of clinical pharmacology and pharmacotherapy, N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia – Russian Gerontological Research and Clinical Center. Address: 129226, Moscow, 16 1st Leonova St.
E-mail: natalyavorobjeva@mail.ru
ORCID: https://orcid.org/0000-0002-6021-7864
Irina P. Malaya, MD, PhD (Medicine), head of the Department of clinical pharmacology and pharmacotherapy, N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia – Russian Gerontological Research and Clinical Center. Address: 129226, Moscow, 16 1st Leonova St.
E-mail: malaya_ip@rgnkc.ru
ORCID: https://orcid.org/0000-0001-5964-5725
Vadim D. Zakiev, MD, junior researcher at the Department of clinical pharmacology and pharmacotherapy, N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia – Russian Gerontological Research and Clinical Center. Address: 129226, Moscow, 16 1st Leonova St.
E-mail: zakiev_vd@rgnkc.ru
ORCID: https://orcid.org/0000-0003-4027-3727
Olga N. Tkacheva, MD, Dr. Sci. (Medicine), professor, director of N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia – Russian Gerontological Research and Clinical Center. Address: 129226, Moscow, 16 1st Leonova St.
E-mail: tkacheva@rgnkc.ru
ORCID: https://orcid.org/0000-0002-4193-688X


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