Characteristics of anticoagulants use as antithrombin-containing medications in patients with coronary heart disease

¹ Department of Internal Medicine, Bukhara State Medical Institute, Bukhara, Republic of Uzbekistan
² Department of Pathological Physiology, Bukhara State Medical Institute, Bukhara, Republic of Uzbekistan

^* Corresponding author: This email address is being protected from spambots. You need JavaScript enabled to view it.

Abstract

This study examines the use of the antithrombotic agents warfarin and Xarelto among patients with coronary heart disease. Research was conducted over 1.5 years (2020–2022) in the Department of Cardiology at the Multidisciplinary Medical Center of the Bukhara region. A total of 76 patients aged 60–74 years (42 men, 34 women; 55.3% and 44.7%, respectively) were included. Among them, 44 patients (36 men, 8 women) with ischemic heart disease required myocardial revascularization, and 33 exhibited persistent atrial fibrillation, including 11 with long-term persistent forms. In this limited observational cohort, patients receiving NOACs (New Oral Anticoagulants), including rivaroxaban, after coronary artery bypass grafting demonstrated fewer thromboembolic and hemorrhagic complications compared with those treated with warfarin. However, due to the restricted sample size, these differences were not statistically significant, highlighting the need for larger clinical trials. In hospitalized coronary artery disease patients with atrial fibrillation, it was noted that 16% received NOAC doses above the therapeutic range. Comparative analysis between rivaroxaban and warfarin showed that patients on warfarin remained within the therapeutic INR range (2–3) only 64% of the time. Overall, the findings support previous evidence that NOACs provide efficacy comparable to warfarin while offering a better safety profile and greater ease of use.