The possibilities of using oral anticoagulant therapy in patients with atrial fibrillation and chronic anemia: a narrative review

The appointment of anticoagulant therapy for atrial fibrillation (AF) plays an important role in preventing thromboembolic complications. The review article discusses the issues of prescribing anticoagulant therapy to patients with AF in combination with chronic anemia of varying severity. Based on the analysis of full-text literature sources dealing with the topic of anticoagulant therapy in patients with AF and anemia and published in the PubMed and Library electronic libraries for the period 2010–2023, the authors conclude that it is currently advisable to prescribe oral anticoagulants to patients with AF and mild chronic anemia (Hb90 g/l), and in some studies and in patients with moderate anemia with hemoglobin Hb 80 g/l, it was confirmed. In patients with AF and anemia of moderate severity, especially at the level of Hb = 71-80 g / l, an individual approach to the appointment of oral anticoagulants is required, since in this subgroup of patients the benefits of their appointment are not obvious, and the risks of hemorrhagic complications are high. Severe anemia is currently a contraindication to taking oral anticoagulants in patients with AF.