russjcardiolРоссийский кардиологический журналRussian Journal of Cardiology1560-40712618-7620«SILICEA-POLIGRAF» LLC10.15829/1560-4071-2020-4178russjcardiol-4178Research ArticleМНЕНИЕ ПО ПРОБЛЕМЕOPINION ON THE ISSUEКоморбидный больной фибрилляцией предсердий в реальной клинической практикеA patient with atrial fibrillation and comorbidities in clinical practicehttps://orcid.org/0000-0003-4294-5814СкотниковА. С.SkotnikovA. S.

Скотников Антон Сергеевич — кандидат медицинских наук, доцент кафедры медико-социальной экспертизы, неотложной и поликлинической терапии.Москва.

Moscow.

skotnikov.as@mail.ruhttps://orcid.org/0000-0003-3288-5168АлгиянЕ. А.AlgiyanE. A.

Заведующий терапевтическим отделением ГКБ № 81 (имени Вересаева) г. Москвы.Москва.

Moscow.

https://orcid.org/0000-0002-1242-7074СизоваЖ. М.SizovaZh. M.

Профессор, доктор медицинских наук, заведующая кафедрой медико-социальной экспертизы, неотложной и поликлинической терапии.Москва.

Moscow.

Первый Московский государственный медицинский университет им. И.М. Сеченова Минздрава России (Сеченовский университет); АНО НИЦ коморбидной патологии “Рациональная медицина”РоссияI.M. Sechenov First Moscow State Medical University; Scientific-Research Center of Comorbid Pathology “Rational Medicine”Russian FederationАНО НИЦ коморбидной патологии “Рациональная медицина”РоссияScientific-Research Center of Comorbid Pathology “Rational Medicine”Russian FederationПервый Московский государственный медицинский университет им. И.М. Сеченова Минздрава России (Сеченовский университет)РоссияI.M. Sechenov First Moscow State Medical UniversityRussian Federation202006112020251141784178Copyright © Скотников А.С., Алгиян Е.А., Сизова Ж.М., 20202020Скотников А.С., Алгиян Е.А., Сизова Ж.М.Skotnikov A.S., Algiyan E.A., Sizova Z.M.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://russjcardiol.elpub.ru/jour/article/view/4178

Настоящая статья посвящена проблеме этиологии и патогенеза неклапанной формы фибрилляции предсердий у коморбидных, в т.ч. пожилых, больных с такими часто встречающимися заболеваниями, как ишемическая болезнь сердца, хроническая сердечная недостаточность, сахарный диабет 2 типа и хроническая болезнь почек. Авторы обсуждают механизмы взаимосвязи и взаимоотягощения фибрилляции предсердий и данных нозологий, а также указывают на необходимость комплексной защиты подобных пациентов (профилактика кардиоэмболического инсульта и прочих системных эмболических событий, снижение коронарного риска, улучшение прогноза, замедление прогрессирования почечной дисфункции, повышение приверженности к терапии и т.д.) посредством назначения адекватной антитромботической терапии, не теряющей эффективности и/или безопасности в условиях обилия болезней и вынужденной полипрагмазии.

This article focuses on the etiology and pathogenesis of nonvalvular atrial fibrillation in patients with comorbidities such as coronary artery disease, heart failure, type 2 diabetes, and chronic kidney disease. The authors discuss the interconnection of atrial fibrillation and these diseases, and also note the need for protection of such patients (prevention of cardioembolic stroke and other systemic embolism, reduction of coronary risk, improvement of prognosis, slowing the progression of renal dysfunction, increasing medical adherence, etc.) by adequate antithrombotic therapy that does not lose effectiveness and/or safety in presence of multiple diseases and polypharmacy.

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The authors declare that there are no conflicts of interest present.