Contribution of anticoagulant therapy adherence to the risk of complications of atrial fibrillation

Abstract

Aim. To study compliance and its role in the development of the fatal complications of anticoagulant therapy in patients with atrial fibrillation (AF). Material and methods. Antithrombotic therapy and compliance were studied in an open observational controlled prospective study with 109 AF patients. The dynamics and presence of thromboembolic and hemorrhagic complications were recorded. Results. For the first time in patients with AF, we detected a significantly high relative risk of development of life-threatening and lethal complications of anticoagulant therapy with warfarin with insufficient compliance (RR=8,0; [1,728;37,027]; p<0,05) and drug therapy (RR=7,0; [1,493;32,819]; p<0,05). At the same time, patients with AF could not detect any links between the level compliance and the risk of treatment with directly acting oral anticoagulants (DAOC) - patients who achieved a common primary endpoint had no association between the relative risk and the level of compliance (RR=1,0; [0,106;9,445]; p<0,05). Conclusion. The study showed for the first time that in patients with AF, the most unfavorable prognostic factor in the development of life-threatening and lethal complications with warfarin taking is low adherence to lifestyle modification and drug therapy. At the same time, in patients with AF, who receive DAOK as anticoagulants, there was no connection between compliance and the development of hemorrhagic or thromboembolic complications.