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Фармакоэпидемиологический анализ стационарного лечения пациентов с инфарктом мозга на фоне фибрилляции предсердий

Фармакоэпидемиологический анализ стационарного лечения пациентов с инфарктом мозга на фоне фибрилляции предсердий

Abstract

Цель. Анализ сложившейся практики лекарственной терапии инфаркта мозга на фоне фибрилляции предсердий (ФП) в неврологических отделениях стационаров Саратова. Материал и методы. Проведено ретроспективное сплошное фармакоэпидемиологическое исследование. Анализировали истории болезни пациентов, госпитализированных в отделения неврологии с 01.01.2009 по 31.12.2011 гг Результаты. 66,7% больных с инфарктом мозга на фоне ФП была назначена ацетилсалициловая кислота. Варфарин назначался 3,9% больных, при этом целевое значение международного нормализованного отношения достигнуто только в 40% случаев. В тоже время выявлено частое (у 96% пациентов) назначение препаратов с низким уровнем доказательности (метаболические, нейропротективные, вазоактивные средства). Для контроля частоты сердечных сокращений во время стационарного лечения в 39,3% случаев назначались β-адреноблокаторы или их комбинация с дигоксином у 18,7% больных. Заключение. В целом выбираемая врачами тактика фармакотерапии инфаркта мозга на фоне ФП не вполне соответствует современным рекомендациям. Достаточно часто для лечения используются препараты с низкой эффективностью и не имеющие доказательной базы.

Aim. To analyze pharmacotherapy of cerebral infarction in patients with atrial fibrillation (AF) in real clinical practice of neurological departments of Saratov hospitals. Material and methods. A retrospective longitudinal pharmacoepidemiologic study was carried out. Medical cards were analyzed in patients with cerebral infarction and atrial fibrillation treated in neurology departments from 01.01.2009 to 31.12.2011. Results. Acetylsalicylic acid was prescribed to 66.7% of patients, warfarin 3.9%. At that target level of international normalised ratio was reached only in 40% of patients. It has been shown frequent (96%) prescriptions of metabolic, neuroprotective and vasoactive drugs with low level of efficacy evidence. Beta-blockers (in 39.3% of patients) and their combination with digoxin (18.7%) were prescribed for heart rate control. Conclusion. Generally, in real clinical practice doctor's choice of pharmacotherapy of cerebral infarction in patients with AF is not exactly in line with contemporary guidelines. These patients are frequently prescribed drugs with low efficacy and level of evidence.

Keywords

ИНФАРКТ МОЗГА, ФИБРИЛЛЯЦИЯ ПРЕДСЕРДИЙ, ФАРМАКОЭПИДЕМИОЛОГИЯ, АНТИТРОМБОТИЧЕСКИЕ СРЕДСТВА, ВТОРИЧНАЯ ПРОФИЛАКТИКА

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
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