Молодежный инновационный вестникМолодежный инновационный вестник2415-7805Федеральное государственное бюджетное образовательное учреждение высшего образования "Воронежский государственный медицинский университет имени Н.Н. Бурденко" Министерства здравоохранения Российской Федерации10317Conference ProceedingsTransition to the usage of direct oral anticoagulants in modern medical practicePolekhinaK. S.<p>Student</p>Polehina.karina@yandex.ruhttps://orcid.org/0009-0000-9666-7501SchukinaE. V.<p>Doctor of Medicine, Head of the Department of internal diseases No. 1</p>schukina.elena@mail.ruhttps://orcid.org/0000-0002-9022-6155Donetsk State Medical University named after M. Gorky2504202514S14934952202202525022025Copyright © 2025, Polekhina K.S., Schukina E.V.2025<p>Using of warfarin is an affordable and effective method for the treatment and prevention of thrombotic diseases and conditions. However, due to the fact that warfarin therapy requires additional administration of heparin in the first 4-5 days, careful monitoring of the hemostasis system and the appointment of a special diet, there are certain risks affecting treatment. The new generation of oral anticoagulants avoids the possible complications that arise when choosing warfarin, has a better pharmacological effect, but is a less affordable treatment option. In the course of our study, the advantages and disadvantages of using new oral anticoagulants in thrombotic conditions were studied. Despite the effectiveness and rate of action of new oral anticoagulants, their administration in some conditions has more undesirable effects than warfarin therapy: the appointment of rivaroxaban in antiphospholipid syndrome leads to an increase in the frequency of bleeding, and the use of dabigatran in patients with mechanical heart valves leads to an increase in the frequency of both thromboembolic and hemorrhagic complications. At the same time, dabigatran in isolation showed greater efficacy than warfarin in lower doses. Also, positive effects were observed in people with impaired renal function when using new oral anticoagulants, compared with warfarin therapy. Currently, it is not possible to completely abandon the use of warfarin, but new oral coagulants have significant prospects for widespread use in modern medical practice.</p>oral anticoagulantswarfarin, rivaroxabandabigatranapixabanedoxabanоральные антикоагулянтыварфаринривароксабандабигатранапиксабанэдоксабан1.Fredenburgh JC, Weitz JI. New anticoagulants: Moving beyond the direct oral anticoagulants. J Thromb Haemost. 2021;19(1):20-29. doi:10.1111/jth.151262.Heestermans M, Poenou G, Hamzeh-Cognasse H, Cognasse F, Bertoletti L. Anticoagulants: A Short History, Their Mechanism of Action, Pharmacology, and Indications. Cells. 2022;11(20):3214. Published 2022 Oct 13. doi:10.3390/cells112032143.Keisu M, Andersson TB. Drug-induced liver injury in humans: the case of ximelagatran. Handb Exp Pharmacol. 2010;(196):407-418. doi:10.1007/978-3-642-00663-0_134.Stöhr R, Reinartz S, Dirrichs T, Witte K, Schuh A, Brandenburg V. Rivaroxaban versus vitamin K antagonist treatment on the progression of coronary calcification: the IRIVASC-trial. Sci Rep. 2024;14(1):17605. Published 2024 Jul 30. doi:10.1038/s41598-024-67657-85.Pengo V, Denas G, Zoppellaro G, et al. Rivaroxaban vs warfarin in high-risk patients with antiphospholipid syndrome. Blood. 2018;132(13):1365-1371. doi:10.1182/blood-2018-04-8483336.Ordi-Ros J, Sáez-Comet L, Pérez-Conesa M, et al. Rivaroxaban Versus Vitamin K Antagonist in Antiphospholipid Syndrome: A Randomized Noninferiority Trial. Ann Intern Med. 2019;171(10):685-694. doi:10.7326/M19-02917.Eikelboom JW, Connolly SJ, Brueckmann M, et al. Dabigatran versus warfarin in patients with mechanical heart valves. N Engl J Med. 2013;369(13):1206-1214. doi:10.1056/NEJMoa13006158.Maeng M, Steg PG, Bhatt DL, et al. Dabigatran Dual Therapy Versus Warfarin Triple Therapy Post-PCI in Patients With Atrial Fibrillation and Diabetes. JACC Cardiovasc Interv. 2019;12(23):2346-2355. doi:10.1016/j.jcin.2019.07.0599.Stanifer JW, Pokorney SD, Chertow GM, et al. Apixaban Versus Warfarin in Patients With Atrial Fibrillation and Advanced Chronic Kidney Disease. Circulation. 2020;141(17):1384-1392. doi:10.1161/CIRCULATIONAHA.119.04405910.Harrington J, Carnicelli AP, Hua K, et al. Direct Oral Anticoagulants Versus Warfarin Across the Spectrum of Kidney Function: Patient-Level Network Meta-Analyses From COMBINE AF. Circulation. 2023;147(23):1748-1757. doi:10.1161/CIRCULATIONAHA.122.062752