Specific aspects of using apixaban in outpatient physician practice

A.D. Erlikh 

Pirogov Russian National Research Medical University, Moscow

N.E. Bauman City Clinical Hospital No. 29, Moscow 

The article identifies and describes the tasks of an outpatient physician (general practitioner, therapist, cardiologist and other specialists) associated with the use of oral anticoagulants with a focus on apixaban. The authors highlight special aspects of the decision-making process associated with the initiation of anticoagulant therapy in patients with atrial fibrillation and emphasize the need for selecting the right dose of each on non-vitamin K direct oral anticoagulants (DOAC). The article presents a set of factors which should be evaluated by a physician prior to DOAC administration to minimize the risk of future therapy complications. It also describes approaches to the management of patients taking DOAC, follow-up visit schedules, and factors to be taken into consideration during follow-up of such patients. The authors outline criteria for changing DOAC dosages during the treatment w hich is essential for patients with decreased glomerular filtration rate and individuals receiving combination therapy (antiaggregant agent and DOAC) after the recent acute myocardial infarction and/or percutaneous coronary intervention. The emphasis is made on the management of patients who survived an episode of acute thromboembolism of pulmonary artery and/or had deep vein thrombosis of the legs.

Keywords: direct oral anticoagulant, atrial fibrillation, TEPA, myocardial infarction, outpatient treatment, outpatient physician.

For citation: Erlikh A.D. Specific aspects of using apixaban in outpatient physician practice. RMJ. 2022;9:29–34.