7. WHAT SCALES SHOULD THE CARDIOLOGIST USE IN PATIENTS WITH ATRIAL FIBRILLATION? WHAT IS NEW?

Authors

  • K.A. Bizhanov Almaty, Kazakhstan 3NEI "Kazakh-Russian Medical University", Almaty, Kazakhstan, 3НУО "Казахстанско-Российский Медицинский Университет", Алматы, Казахстан https://orcid.org/0000-0002-6668-7373
  • A.K. Baimbetov Almaty, Kazakhstan 3NEI "Kazakh-Russian Medical University", Almaty, Kazakhstan, 3НУО "Казахстанско-Российский Медицинский Университет", Алматы, Казахстан https://orcid.org/0000-0003-4553-4287
  • B.B. Baimakhanov Almaty, Kazakhstan 3NEI "Kazakh-Russian Medical University", Almaty, Kazakhstan, 3НУО "Казахстанско-Российский Медицинский Университет", Алматы, Казахстан https://orcid.org/0000-0003-0049-5886
  • Sh.A. Kaniev Almaty, Kazakhstan 3NEI "Kazakh-Russian Medical University", Almaty, Kazakhstan, 3НУО "Казахстанско-Российский Медицинский Университет", Алматы, Казахстан https://orcid.org/0000-0002-1288-0987
  • O.T. Ibekenov Almaty, Kazakhstan 3NEI "Kazakh-Russian Medical University", Almaty, Kazakhstan, 3НУО "Казахстанско-Российский Медицинский Университет", Алматы, Казахстан https://orcid.org/0000-0001-6605-6435
  • A.B. Sarsenbaeva Almaty, Kazakhstan 3NEI "Kazakh-Russian Medical University", Almaty, Kazakhstan, 3НУО "Казахстанско-Российский Медицинский Университет", Алматы, Казахстан https://orcid.org/0000-0002-7890-0047
  • G.N. Ismailova Almaty, Kazakhstan 3NEI "Kazakh-Russian Medical University", Almaty, Kazakhstan, 3НУО "Казахстанско-Российский Медицинский Университет", Алматы, Казахстан https://orcid.org/0000-0002-7461-4190

DOI:

https://doi.org/10.35805/BSK2024II007

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Abstract

The current treatment algorithm for patients with non-valvular atrial fibrillation (AF) includes anticoagulation to prevent stroke and systemic embolism, improvement of AF symptom control by heart rate reduction or restoration and maintenance of sinus rhythm, and treatment of cardiovascular and other comorbidities. The evaluation of patients with AF should be structured and include assessment of stroke risk, symptom severity, severity of the AF burden (type of arrhythmia, number and duration of episodes, etc.) and predisposing condition. The use of the CHA2DS2-VASc (risk of stroke), HAS-BLED (risk of bleeding), EHRA (severity of AF symptoms), and 2MACE (risk of cardiovascular outcomes) scales is important to help assess the likelihood of adverse outcomes and select the optimal treatment to protect not only against stroke but also against cardiovascular events. It should be noted that the HAS-BLED scale is primarily necessary for identification of bleeding risk factors, the modification of which allows to increase the safety of anticoagulant therapy, and a high index value according to this scale can’t serve as a reason to refuse anticoagulation in a patient with AF. New scales of stroke and hemorrhagic complications risk assessment in patients with AF on the basis of clinical parameters and laboratory biomarkers have been proposed, but their possible advantages over the existing indices need to be confirmed in special studies.

Keywords

Atrial fibrillation, stroke, bleeding, scales, direct oral anyicoagulants, myocardial infarction, interventional arrhythmology, cardiology

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Published

2024-06-28

Issue

No. 2 (2024)

Section

Статьи