arthyperАртериальная гипертензия"Arterial’naya Gipertenziya" ("Arterial Hypertension")1607-419X2411-8524Antihypertensive League10.18705/1607-419X-2014-20-5-361-369arthyper-69Research ArticleЛЕКЦИЯLECTUREОСТРЫЙ КОРОНАРНЫЙ СИНДРОМ У ПАЦИЕНТОВ С ФИБРИЛЛЯЦИЕЙ ПРЕДСЕРДИЙ: ВОЗМОЖНОСТИ ИСПОЛЬЗОВАНИЯ СОВРЕМЕННЫХ АНТИКОАГУЛЯНТОВACUTE CORONARY SYNDROME IN PATIENTS WITH ATRIAL FIBRILLATION: THE POSSIBILITIES OF MODERN ANTICOAGULANTSШахновичП. Г.ShakhnovichP. G.

Кандидат медицинских наук, докторант кафедры военно-морской терапии ВМА им. С.М. Кирова 

dm-cherk@yandex.ruБалахновД. О.BalakhnovD. O.

Главный терапевт ФГКУ «1469 Военно-морской клинический госпиталь»

dm-cherk@yandex.ruЧеркашинД. В.CherkashinD. V.

Доктор медицинских наук, начальник кафедры военно-морской терапии ВМА им. С.М. Кирова

Контактная информация: ФГБВОУ ВПО «Военно-медицинская академия имени С.М. Кирова» Минобороны России,  ул. Академика Лебедева, д. 6, Санкт-Петербург, Россия, 194044. Факс: +7(812)316–53–07. E-mail: dm-cherk@yandex.ru (Черкашин Дмитрий Викторович).

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Corresponding author: KirovMilitaryMedicalAcademy,6 Academician Lebedev street,St Petersburg,Russia, 194044. Fax: +7(812)316–53–07. MD, PhD, the Chief of the Naval Medicine Department atKirovMilitaryMedicalAcademy

dm-cherk@yandex.ruАланичевА. Е.AlanichevA. E.

Кандидат медицинских наук, преподаватель кафедры военно-морской терапии ВМА им. С.М. Кирова

dm-cherk@yandex.ruВоенно-медицинская академия имени С.М. Кирова, Санкт-ПетербургРоссияKirov Military Medical Academy, St PetersburgRussian Federation1469 Военно-морской клинический госпиталь, СевероморскРоссияNaval Hospital 1469, SeveromorskRussian Federation201427022015205361369Copyright © Шахнович П.Г., Балахнов Д.О., Черкашин Д.В., Аланичев А.Е., 20152015Шахнович П.Г., Балахнов Д.О., Черкашин Д.В., Аланичев А.Е.Shakhnovich P.G., Balakhnov D.O., Cherkashin D.V., Alanichev A.E.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/69

В статье приведены обзорные данные, которые освещают современные подходы к назначению пероральных антикоагулянтов у больных фибрилляцией предсердий при развитии острого коронарного синдрома. В данной клинической ситуации необходима комбинация двух антиагрегантных препаратов в сочетании с антикоагулянтом, драматически увеличивающая риск кровотечений. В соответствии с накопленными научными данными и международными рекомендациями обобщены основные подходы к лечению больных на разных стадиях заболевания.

Review of the literature shows modern approaches to prescription of oral anticoagulants in patients with atrial fibrillation in the development of acute coronary syndrome. This clinical situation requires a comb of two antiplatelet drugs in combination with an anticoagulant, dramatically increasing the risk of bleeding. In accordance with the accumulated scientific data and international guidelines the basic approaches to the treatment of patients at different stages of the disease are generalized.

фибрилляция предсердийострый коронарный синдромантиагрегантыантикоагулянтыatrial fibrillationacute coronary syndromeplatelet antiaggregantsanticoagulantsReferencesCamm A.J. Atrial fibrillation and risk // Clin. Cardiol. —2012. — Vol. 35, Supp. 1. — P. 1–2.Camm A.J. Atrial fibrillation and risk // Clin. Cardiol. —2012. — Vol. 35, Supp. 1. — P. 1–2.Saczynski J.S., McManus D., Zhou Z. et al. Trends in atrial fibrillation complicating acute myocardial infarction // Am. J. Cardiol. — 2009. — Vol. 104, № 2. — P. 169–174.Saczynski J.S., McManus D., Zhou Z. et al. Trends in atrial fibrillation complicating acute myocardial infarction // Am. J. Cardiol. — 2009. — Vol. 104, № 2. — P. 169–174.Lopes R.D., Pieper K.S., Horton J.R. et al. Short- and long-term outcomes following atrial fibrillation in patients with acute coronary syndromes with or without ST-segment elevation // Heart. — 2008. — Vol. 94, № 7. — P. 867–873.Lopes R.D., Pieper K.S., Horton J.R. et al. Short- and long-term outcomes following atrial fibrillation in patients with acute coronary syndromes with or without ST-segment elevation // Heart. — 2008. — Vol. 94, № 7. — P. 867–873.Jabre P., Roger V.L., Murad M.H. et al. Mortality associated with atrial fibrillation in patients with myocardial infarction: a systematic review and meta-analysis // Circulation. — 2011. — Vol. 123, № 15. — P. 1587–1593.Jabre P., Roger V.L., Murad M.H. et al. Mortality associated with atrial fibrillation in patients with myocardial infarction: a systematic review and meta-analysis // Circulation. — 2011. — Vol. 123, № 15. — P. 1587–1593.Диагностика и лечение фибрилляции предсердий. Рекомендации РКО, ВНОА, АССХ // Рос. кардиол. журн. — 2013. — Т. 4, № 102, прил. 1. — С. 1–100. / National Guidelines of Atrial Fibrillation 2012 // Russian Cardiology Journal [Rossiiskii kardiologicheskii zhurnal]. — 2013. — Vol. 4, № 102, Appendix 1. — P. 1–100 [Russian].Диагностика и лечение фибрилляции предсердий. Рекомендации РКО, ВНОА, АССХ // Рос. кардиол. журн. — 2013. — Т. 4, № 102, прил. 1. — С. 1–100. / National Guidelines of Atrial Fibrillation 2012 // Russian Cardiology Journal [Rossiiskii kardiologicheskii zhurnal]. — 2013. — Vol. 4, № 102, Appendix 1. — P. 1–100 [Russian].Hamm C.W., Bassand J.P., Agewall S. et al. ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation: The Task Force for the management of acute coronary syndromes (ACS) in patients presenting without persistent ST-segment elevation of the European Society of Cardiology (ESC) // Eur. Heart. J. — 2011. — Vol. 32, № 23. — P. 2999–3054.Hamm C.W., Bassand J.P., Agewall S. et al. ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation: The Task Force for the management of acute coronary syndromes (ACS) in patients presenting without persistent ST-segment elevation of the European Society of Cardiology (ESC) // Eur. Heart. J. — 2011. — Vol. 32, № 23. — P. 2999–3054.Lip G.Y., Tse H.F., Lane D.A. Atrial fibrillation // Lancet. — 2012. — Vol. 379, № 9816. — P. 648–661.Lip G.Y., Tse H.F., Lane D.A. Atrial fibrillation // Lancet. — 2012. — Vol. 379, № 9816. — P. 648–661.Granger С.B., Alexander J.H., McMurray J.J. et al. for the ARISTOTLE Committees and Investigators. Apixaban versus warfarin in patients with atrial Fibrillation // N. Engl. J. Med. — 2011. — Vol. 365, № 11. — P. 981–992.Granger С.B., Alexander J.H., McMurray J.J. et al. for the ARISTOTLE Committees and Investigators. Apixaban versus warfarin in patients with atrial Fibrillation // N. Engl. J. Med. — 2011. — Vol. 365, № 11. — P. 981–992.Patel M.R., Mahaffey K.W., Garg J. et al. for the ROCKETAF Investigators. Rivaroxaban versus warfarin in non-valvular atrial fibrillation // N. Engl. J. Med. — 2011. — Vol. 365, № 10. — P. 883–891.Patel M.R., Mahaffey K.W., Garg J. et al. for the ROCKETAF Investigators. Rivaroxaban versus warfarin in non-valvular atrial fibrillation // N. Engl. J. Med. — 2011. — Vol. 365, № 10. — P. 883–891.Camm A.J., Lip G.Y.H., De Caterina R. et al. 2012 focused update of the ESC Guidelines for the management of atrial fibrillation. An update of the 2010 ESC Guidelines for the management of atrial fibrillation // Eur. Heart. J. — 2012. — Vol. 33, № 21. — P. 2719–2749.Camm A.J., Lip G.Y.H., De Caterina R. et al. 2012 focused update of the ESC Guidelines for the management of atrial fibrillation. An update of the 2010 ESC Guidelines for the management of atrial fibrillation // Eur. Heart. J. — 2012. — Vol. 33, № 21. — P. 2719–2749.Heidbuchel H., Verhamme P., Alings M. et al. European Heart Rhythm Association Practical Guide on the use of new oral anticoagulants in patients with non-valvular atrial fibrillation // Europace. — 2013. — Vol. 15, № 5. — P. 625–651.Heidbuchel H., Verhamme P., Alings M. et al. European Heart Rhythm Association Practical Guide on the use of new oral anticoagulants in patients with non-valvular atrial fibrillation // Europace. — 2013. — Vol. 15, № 5. — P. 625–651.January C.T., Wann S.T., Alpert J.S. et al. 2014 AHA/ACC/ HRS guideline for the management of patients with atrial fibrillation. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the Heart Rhythm Society: Executive summary // J. Am. Coll. Cardiol. — 2014. [Electronic resource]. — URL: http://content.onlinejacc.org/ pdfaccess.ashx?ResourceID=6551685&PDFSource=13January C.T., Wann S.T., Alpert J.S. et al. 2014 AHA/ACC/ HRS guideline for the management of patients with atrial fibrillation. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the Heart Rhythm Society: Executive summary // J. Am. Coll. Cardiol. — 2014. [Electronic resource]. — URL: http://content.onlinejacc.org/ pdfaccess.ashx?ResourceID=6551685&PDFSource=13Fuster V., Ryden L.E., Cannom D.S. et al. ACC/AHA/ ESC 2006 guidelines for the management of patients with atrial fibrillation // Circulation. — 2006. — Vol. 114, № 7. — P. e257– e354.Fuster V., Ryden L.E., Cannom D.S. et al. ACC/AHA/ ESC 2006 guidelines for the management of patients with atrial fibrillation // Circulation. — 2006. — Vol. 114, № 7. — P. e257– e354.Wann L.S., Curtis A.B., Ellenbogen K.A. et al. 2011 ACCF/ AHA/HRS focused update on the management of patients with atrial fibrillation (update on dabigatran): A report of the American College of Cardiology Foundation/American Heart Association Task Force on practice guidelines // J. Am. Coll. Cardiol. — 2011. — Vol. 57, № 11. — P. 1330–1337.Wann L.S., Curtis A.B., Ellenbogen K.A. et al. 2011 ACCF/ AHA/HRS focused update on the management of patients with atrial fibrillation (update on dabigatran): A report of the American College of Cardiology Foundation/American Heart Association Task Force on practice guidelines // J. Am. Coll. Cardiol. — 2011. — Vol. 57, № 11. — P. 1330–1337.Wann L.S., Curtis A.B., January C.T. et al. 2011 ACCF/ AHA/HRS focused update on the management of patients with atrial fibrillation (updating the 2006 guideline): A report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines // J. Am. Coll. Cardiol. — 2011. — Vol. 57, № 2. — P. 223–242.Wann L.S., Curtis A.B., January C.T. et al. 2011 ACCF/ AHA/HRS focused update on the management of patients with atrial fibrillation (updating the 2006 guideline): A report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines // J. Am. Coll. Cardiol. — 2011. — Vol. 57, № 2. — P. 223–242.Chan M.Y., Sun J.L., Newby L.K. et al. Long-term mortality of patients undergoing cardiac catheterization for ST-elevation and non-st-elevation myocardial infarction // Circulation. — 2009. — Vol. 119, № 24. — P. 3110–3117.Chan M.Y., Sun J.L., Newby L.K. et al. Long-term mortality of patients undergoing cardiac catheterization for ST-elevation and non-st-elevation myocardial infarction // Circulation. — 2009. — Vol. 119, № 24. — P. 3110–3117.Vlaar P.J., Svilaas T., van der Horst I.C. et al. Cardiac death and reinfarction after 1 year in the Thrombus Aspiration during Percutaneous coronary intervention in Acute myocardial infarction Study (TAPAS): a 1-year follow-up study // Lancet. — 2008. — Vol. 371, № 9628. — P. 1915–1920.Vlaar P.J., Svilaas T., van der Horst I.C. et al. Cardiac death and reinfarction after 1 year in the Thrombus Aspiration during Percutaneous coronary intervention in Acute myocardial infarction Study (TAPAS): a 1-year follow-up study // Lancet. — 2008. — Vol. 371, № 9628. — P. 1915–1920.2013 ACCF/AHA Guideline for the Management of STElevation Myocardial Infarction. A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines // J. Am. Coll. Cardiol. — 2013. — Vol. 61, № 4. [Electronic resource]. — URL: http://content.onlinejacc.org/ article.aspx?articleID=14863522013 ACCF/AHA Guideline for the Management of STElevation Myocardial Infarction. A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines // J. Am. Coll. Cardiol. — 2013. — Vol. 61, № 4. [Electronic resource]. — URL: http://content.onlinejacc.org/ article.aspx?articleID=1486352ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation. The Task Force on the management of ST-segment elevation acute myocardial infarction of the European Society of Cardiology (ESC) // Eur. Heart. J. — 2012. [Electronic resource]. — URL: http://eurheartj.oxfordjournals.org/content/early/2012/08/23/ eurheartj.ehs215.full.pdf.ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation. The Task Force on the management of ST-segment elevation acute myocardial infarction of the European Society of Cardiology (ESC) // Eur. Heart. J. — 2012. [Electronic resource]. — URL: http://eurheartj.oxfordjournals.org/content/early/2012/08/23/ eurheartj.ehs215.full.pdf.2012 focused update of the ESC Guidelines for the management of atrial fibrillation. An update of the 2010 ESC Guidelines for the management of atrial fibrillation. Developed with the special contribution of the European Heart Rhythm Association // Eur. Heart. J. — 2012. [Electronic resource]. — URL: http://eurheartj.oxfordjournals.org/content/33/21/2719.full.pdf2012 focused update of the ESC Guidelines for the management of atrial fibrillation. An update of the 2010 ESC Guidelines for the management of atrial fibrillation. Developed with the special contribution of the European Heart Rhythm Association // Eur. Heart. J. — 2012. [Electronic resource]. — URL: http://eurheartj.oxfordjournals.org/content/33/21/2719.full.pdfVandvik P.O., Lincoff A.M., Gore J.M. et al. Primary and secondary prevention of cardiovascular disease. antithrombotic therapy and prevention of thrombosis, 9th ed: American College of chest physicians evidence-based clinical practice guidelines // Chest. — 2012. — Vol. 141, Suppl. — P. e637S–e668S.Vandvik P.O., Lincoff A.M., Gore J.M. et al. Primary and secondary prevention of cardiovascular disease. antithrombotic therapy and prevention of thrombosis, 9th ed: American College of chest physicians evidence-based clinical practice guidelines // Chest. — 2012. — Vol. 141, Suppl. — P. e637S–e668S.Harrington R.A., Becker R.C., Cannon C.P. et al. Antithrombotic therapy for non-ST-segment elevation acute coronary syndromes. American College of chest physicians evidence-based clinical practice guidelines (8th Edition) // Chest. — 2008. — Vol. 133, № 6, Suppl. — P. 670S–707S.Harrington R.A., Becker R.C., Cannon C.P. et al. Antithrombotic therapy for non-ST-segment elevation acute coronary syndromes. American College of chest physicians evidence-based clinical practice guidelines (8th Edition) // Chest. — 2008. — Vol. 133, № 6, Suppl. — P. 670S–707S.Guidelines for the diagnosis and treatment of non-STsegment elevation acute coronary syndromes. The Task Force for the Diagnosis and Treatment of Non-ST-Segment Elevation Acute Coronary Syndromes of the European Society of Cardiology // Eur. Heart. J. — 2007. — Vol. 28, № 13. — P. 1598–1660.Guidelines for the diagnosis and treatment of non-STsegment elevation acute coronary syndromes. The Task Force for the Diagnosis and Treatment of Non-ST-Segment Elevation Acute Coronary Syndromes of the European Society of Cardiology // Eur. Heart. J. — 2007. — Vol. 28, № 13. — P. 1598–1660.Granger C.B., Goldberg R.J., Dabbous O. et al. Predictors of hospital mortality in the Global Registry of Acute Coronary Events // Arch. Intern. Med. — 2003. — Vol. 163, № 19. — P. 2345–2353.Granger C.B., Goldberg R.J., Dabbous O. et al. Predictors of hospital mortality in the Global Registry of Acute Coronary Events // Arch. Intern. Med. — 2003. — Vol. 163, № 19. — P. 2345–2353.Subherwal S., Bach R.G., Chen A.Y. et al. Baseline risk of major bleedingin non-ST-segment-elevation myocardial infarction: the CRUSADE (Can Rapid risk stratification of Unstable angina patients Suppress Adverse outcomes with Early implementation of the ACC/AHA Guidelines) Bleeding Score // Circulation. — 2009. — Vol. 119, № 14. — P. 1873–1882.Subherwal S., Bach R.G., Chen A.Y. et al. Baseline risk of major bleedingin non-ST-segment-elevation myocardial infarction: the CRUSADE (Can Rapid risk stratification of Unstable angina patients Suppress Adverse outcomes with Early implementation of the ACC/AHA Guidelines) Bleeding Score // Circulation. — 2009. — Vol. 119, № 14. — P. 1873–1882.Dewilde W.J.M. WOEST: First randomized trial that compares two different regimens with and without aspirin in patients on oral anticoagulant therapy (OAC) undergoing coronary stent placement (PCI). Presented at: European Society of Cardiology Congress; August 28, 2012; Munich, Germany. [Electronic resource]. — URL: http://www.tctmd.com/show.aspx?id=113292 27. Сулимов ВА. Комментарии к рекомендациям европейского общества кардиологов по диагностике и лечению фибрилляции предсердий 2010 года // Рацион. фармакотер. кардиол. — 2011. — Т. 7, № 1–2, приложение. — С. 67–72. / Sulimov V.A. Comments on the European Society of Cardiology Guidelines for the management of atrial fibrillation (2010) // Rational Pharmacotherapy in Cardiology [Ratsionalnaia farmakoterapiia v kardiologii]. — 2011. — Vol. 7, № 1–2, Suppl. — P. 67–72 [Russian].Dewilde W.J.M. WOEST: First randomized trial that compares two different regimens with and without aspirin in patients on oral anticoagulant therapy (OAC) undergoing coronary stent placement (PCI). Presented at: European Society of Cardiology Congress; August 28, 2012; Munich, Germany. [Electronic resource]. — URL: http://www.tctmd.com/show.aspx?id=113292 27. Сулимов ВА. Комментарии к рекомендациям европейского общества кардиологов по диагностике и лечению фибрилляции предсердий 2010 года // Рацион. фармакотер. кардиол. — 2011. — Т. 7, № 1–2, приложение. — С. 67–72. / Sulimov V.A. Comments on the European Society of Cardiology Guidelines for the management of atrial fibrillation (2010) // Rational Pharmacotherapy in Cardiology [Ratsionalnaia farmakoterapiia v kardiologii]. — 2011. — Vol. 7, № 1–2, Suppl. — P. 67–72 [Russian].Management of acute myocardial infarction in patients presenting with persistent ST-segment elevation. The Task Force on the management of ST-segment elevation acute myocardial infarction of the European Society of Cardiology // Eur. Heart J. — 2008. — Vol. 29, № 23. — P. 2909–2345.Management of acute myocardial infarction in patients presenting with persistent ST-segment elevation. The Task Force on the management of ST-segment elevation acute myocardial infarction of the European Society of Cardiology // Eur. Heart J. — 2008. — Vol. 29, № 23. — P. 2909–2345.Kearon C., Akl E.A, Comerota A.J. et al. Antithrombotic Therapy for VTE Disease. Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines // Chest. — 2012. — Vol. 141, Suppl. — P. e419S–e494S.Kearon C., Akl E.A, Comerota A.J. et al. Antithrombotic Therapy for VTE Disease. Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines // Chest. — 2012. — Vol. 141, Suppl. — P. e419S–e494S.Guidelines on the management of valvular heart disease (version 2012). The Joint Task Force on the Management of Valvular Heart Disease of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS) // Eur. Heart. J. — 2012. [Electronic resource]. — URL: http://eurheartj. oxfordjournals.org/content/33/19/2451.full.pdfGuidelines on the management of valvular heart disease (version 2012). The Joint Task Force on the Management of Valvular Heart Disease of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS) // Eur. Heart. J. — 2012. [Electronic resource]. — URL: http://eurheartj. oxfordjournals.org/content/33/19/2451.full.pdfAnand S.S., Yusuf S. Oral anticoagulants therapy in patients with coronary artery disease. A meta-analysis // J. Am. Med. Acad. — 1999. — Vol. 282, № 21. — P. 2058–2067.Anand S.S., Yusuf S. Oral anticoagulants therapy in patients with coronary artery disease. A meta-analysis // J. Am. Med. Acad. — 1999. — Vol. 282, № 21. — P. 2058–2067.Rothberg M.B., Celestin C., Fiore L.D., Lawler E., Cook J.R. Warfarin plus aspirin after myocardial infarction or the acute coronary syndrome: meta-analysis with estimates of risk and benefit // Ann. Intern. Med. — 2005. — Vol. 143, № 4. — P. 241–250.Rothberg M.B., Celestin C., Fiore L.D., Lawler E., Cook J.R. Warfarin plus aspirin after myocardial infarction or the acute coronary syndrome: meta-analysis with estimates of risk and benefit // Ann. Intern. Med. — 2005. — Vol. 143, № 4. — P. 241–250.Andreotti F., Testa L., Biondi-Zoccai G.G., Crea F. Aspirin plus warfarin compared to aspirin alone after acute coronary syndromes: an updated and comprehensive meta-analysis of 25 307 patients // Eur. Heart. J. — 2006. — Vol. 27, № 5. — P. 519–526.Andreotti F., Testa L., Biondi-Zoccai G.G., Crea F. Aspirin plus warfarin compared to aspirin alone after acute coronary syndromes: an updated and comprehensive meta-analysis of 25 307 patients // Eur. Heart. J. — 2006. — Vol. 27, № 5. — P. 519–526.Connolly S., Ezekowitz M.D., Ysuf S. et al. DabigatranConnolly S., Ezekowitz M.D., Ysuf S. et al. Dabigatranversus warfarin in patients with atrial fibrillation // N. Engl. J. Med. — 2009. — Vol. 361, № 12. — P. 1139–1151.versus warfarin in patients with atrial fibrillation // N. Engl. J. Med. — 2009. — Vol. 361, № 12. — P. 1139–1151.Giugliano R.P., Ruff C.T., Braunwald E. et al. Edoxaban versus warfarin in patients with atrial fibrillation // N. Engl. J. Med. — 2013. — Vol. 369, № 22. — P. 2093–2104.Giugliano R.P., Ruff C.T., Braunwald E. et al. Edoxaban versus warfarin in patients with atrial fibrillation // N. Engl. J. Med. — 2013. — Vol. 369, № 22. — P. 2093–2104.Mega J.L., Braunwald E., Mohanavelu S. et al. on behalf of the ATLAS ACS-TIMI 46 study group. Rivaroxaban versus placebo in patients with acute coronary syndromes (ATLAS ACS-TIMI 46): a randomised, double-blind, phase II trial // Lancet. — 2009. — Vol. 374, № 9683. — P. 29–38. 37. Mega J.L., Braunwald E., Wiviott S.D. et al. Rivaroxaban in patients with a recent acute coronary syndrome // N. Engl. J. Med. — 2012. — Vol. 366, № 1. — P. 9–19.Mega J.L., Braunwald E., Mohanavelu S. et al. on behalf of the ATLAS ACS-TIMI 46 study group. Rivaroxaban versus placebo in patients with acute coronary syndromes (ATLAS ACS-TIMI 46): a randomised, double-blind, phase II trial // Lancet. — 2009. — Vol. 374, № 9683. — P. 29–38. 37. Mega J.L., Braunwald E., Wiviott S.D. et al. Rivaroxaban in patients with a recent acute coronary syndrome // N. Engl. J. Med. — 2012. — Vol. 366, № 1. — P. 9–19.Mak K.H. Coronary and mortality risk of novel oral antithrombotic agents: a meta-analysis of large randomised trials // Br. Med. J. Open. — 2012. — [Electronic resource]. — URL: http:// bmjopen.bmj.com/content/2/5/e001592.fullMak K.H. Coronary and mortality risk of novel oral antithrombotic agents: a meta-analysis of large randomised trials // Br. Med. J. Open. — 2012. — [Electronic resource]. — URL: http:// bmjopen.bmj.com/content/2/5/e001592.fullMega J.L. Braunwald E., Murphy S.A. et al. Rivaroxaban in patients stabilized after a ST-segment elevation myocardial infarction: results from the ATLAS ACS-2-TIMI-51 Trial (Anti- Xa therapy to lower cardiovascular events in addition to standard therapy in subjects with acute coronary syndrome-thrombolysis in myocardial infarction-51) // J. Am. Coll. Cardiol. — 2013. — Vol. 61, № 18. — P. 1853–1859.Mega J.L. Braunwald E., Murphy S.A. et al. Rivaroxaban in patients stabilized after a ST-segment elevation myocardial infarction: results from the ATLAS ACS-2-TIMI-51 Trial (Anti- Xa therapy to lower cardiovascular events in addition to standard therapy in subjects with acute coronary syndrome-thrombolysis in myocardial infarction-51) // J. Am. Coll. Cardiol. — 2013. — Vol. 61, № 18. — P. 1853–1859.Dans A.L., Connolly S.J., Wallentin L. et al. Concomitant use of antiplatelet therapy with dabigatran or warfarin in the randomized evaluation of long-term anticoagulation therapy (RE-LY) Trial // Circulation. — 2013. — Vol. 127, № 5. —P. 634–640.Dans A.L., Connolly S.J., Wallentin L. et al. Concomitant use of antiplatelet therapy with dabigatran or warfarin in the randomized evaluation of long-term anticoagulation therapy (RE-LY) Trial // Circulation. — 2013. — Vol. 127, № 5. —P. 634–640.

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