Opolonska N. Prevalence of the risk factors of thromboembolic complications development among the patients with atrial fibrillation and analysis of the methods to improve prognosis

This dissertation deals with management optimization of the patients with atrial fibrillation on the basis of studying the prevalence of the risk factors of thromboembolic complications development according to CHADS2, CHA2DS2-VASс and HAS-BLED scales. For this purpose, 318 patients with paroxysmal, persistent and permanent form of atrial fibrillation were examined. It was found that the most common risk factors of thromboembolic complications which influence the course of atrial fibrillation are the presence of the hypertension, diabetes, heart failure, stroke in anamnesis, age of 75 years and over. It was discovered that the risk of the complications development is also associated with a presence of stable angina of III FC (functional class) and stable angina of III FC in combination with postinfarction cardiosclerosis, stomach ulcer and smoking. Among patients with atrial fibrillation we conducted genetic research of P450-CYP2C9*2/*3 cytochrome, where the dependence between genotype and selected preventive dose of warfarin was found. Using rivaroxaban in comparison with warfarin showed a positive effect in anticoagulant therapy among the patients with atrial fibrillation. Patients of rivaroxaban group have significantly less number of cerebral hemorrhages and bleedings into the critical organs and bleedings which cause fatal outcome, than the patients which are taking warfarin