Total effect of anticoagulant therapy in patients with atrial fibrillation and chronic obstructive pulmonary disease
Aim. To study the total effect of anticoagulant therapy in patients with atrial fibrillation and chronic obstructive pulmonary disease using the method of thrombodynamics. Materials and methods. In the observational cohort study, 67 patients were observed whose average age was 61 ± 0.8 years. Including 32 patients with persistent form of AF and COPD and 35 patients with AF without accompaniment of COPD, receiving anticoagulant therapy. Depending on the intake of various forms of oral anticoagulants, the patients were divided into 4 groups that were comparable by sex and age. The work was performed taking into account the requirements of biomedical ethics; voluntary informed consent was obtained for the inclusion of patients in the study. The examination of hemodynamic function is performed in the laboratory diagnostic system «T-2 thrombodynamic recorder». Results. The best tendency to develop hypocoagulation was observed in patients with COPD, who received warfarin: they had the longest clot growth delay (Tlag) and small initial (Vi) and stationary (Vst) clot growth rates, the average values of which went beyond the reference range and corresponded to the target state of the hypocoagulation indicators. The average indices of thrombodynamics in patients who received Apixaban and Rivaroxaban fit into the reference range and corresponded to the state of normal coagulation. In patients who received Dabigatran, the average Tlag and Vi were within normal values, while Vst indicated a hypercoagulable state, which gives a negative assessment of its efficacy in patients with AF and COPD. Conclusion. The cumulative effect of anticoagulants in patients with atrial fibrillation and chronic obstructive pulmonary disease showed that Warfarin was more effective, which makes expedient its use in patients with this comorbidity.