arthyperАртериальная гипертензия"Arterial’naya Gipertenziya" ("Arterial Hypertension")1607-419X2411-8524Antihypertensive League10.18705/1607-419X-2019-25-1-25-33arthyper-1796Research ArticleОБЗОРREVIEWАнтитромботическая терапия у пациентов с легочной артериальной гипертензиейAntithrombotic therapy in patients with pulmonary arterial hypertensionГончароваН. С.GoncharovaN. S.

Гончарова Наталья Сергеевна — кандидат медицинских наук, старший научный сотрудник научно-исследовательского отдела «Некоронарогенные заболевания сердца» 

ул. Аккуратова, д. 2, Санкт-Петербург, 197341

Natalia S. Goncharova, MD, PhD, Senior Researcher, the Noncoronary Disease Department

2 Akkuratov street, St Petersburg, 197341 

goncharova_ns@almazovcentre.ruСимаковаМ. А.SimakovaМ. A.

Симакова Мария Александровна — кандидат медицинских наук, старший научный сотрудник научно-исследовательского отдела «Некоронарогенные заболевания сердца»

Санкт-Петербург

Maria A. Simakova, MD, PhD, Senior Researcher, the Noncoronary Disease Department

St Petersburg

МоисееваО. М.MoiseevaO. M.

Моисеева Ольга Михайловна — доктор медицинских наук, заведующая научно-исследовательским отделом «Некоронарогенные заболевания сердца», директор Института сердца и сосудов

Санкт-Петербург

Olga M. Moiseeva, MD, PhD, DSc, Professor, Head, the Noncoronary Disease Department, Director, Heart and Vessels Institute

St Petersburg

Федеральное государственное бюджетное учреждение   «Национальный медицинский исследовательский центр  имени В. А. Алмазова» Министерства здравоохранения  Российской ФедерацииРоссияAlmazov National Medical Research CenterRussian Federation2019280320192512533Copyright © Гончарова Н.С., Симакова М.А., Моисеева О.М., 20192019Гончарова Н.С., Симакова М.А., Моисеева О.М.Goncharova N.S., Simakova М.A., Moiseeva O.M.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://htn.almazovcentre.ru/jour/article/view/1796

Обнаружение организованных тромбов в мелких артериях легочной артерии при гистологическом исследовании легких у 57% пациентов с идиопатической легочной артериальной гипертензией (ЛАГ) послужило обоснованием для широкого назначения пероральных антикоагулянтов (ОАК) у пациентов с ЛАГ различной этиологии. В последние годы представление о целесообразности назначения терапии ОАК у пациентов с ЛАГ претерпевает существенные изменения с накоплением данных клинических ретроспективных и проспективных исследований с участием пациентов с ЛАГ различной этиологии, получавших и не получавших ОАК. В настоящем обзоре литературы обсуждаются возможные факторы риска тромбообразования и кровотечений у пациентов с ЛАГ, показания, эффективность и безопасность терапии пероральными ОАК.

Histology studies fnd organized thrombi in small pulmonary arteries in 57% patients with idiopathic pulmonary arterial hypertension (PAH). This evidence justifed a rationale for the widespread use of oral anticoagulants (OAK) in patients with PAH of various etiologies. In recent years, the concept of OAK therapy in PAH patients has changed due to the novel data from clinical retrospective and prospective studies involving patients with PAH of various etiologies who have received anticoagulants. The present review discusses possible risk factors for thrombosis and bleeding in patients with PAH, indications, effcacy, and safety of OAK therapy in diverse PAH etiologies.

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