Clinical analysis highlights challenges of managing atrial fibrillation with comorbidities, indicating the need for effective therapy.
This article focuses on the etiology and pathogenesis of nonvalvular atrial fibrillation in patients with comorbidities such as coronary artery disease, heart failure, type 2 diabetes, and chronic kidney disease. The authors discuss the interconnection of atrial fibrillation and these diseases, and also note the need for protection of such patients (prevention of cardioembolic stroke and other systemic embolism, reduction of coronary risk, improvement of prognosis, slowing the progression of renal dysfunction, increasing medical adherence, etc.) by adequate antithrombotic therapy that does not lose effectiveness and/or safety in presence of multiple diseases and polypharmacy.
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Skotnikov et al. (2020) studied this question.
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