[Long-term therapy with anticoagulants in patients with nonvalvular atrial fibrillation (prospective follow-up). Part I. Effect of 12-month therapy with acenocoumarol on content of d-dimer, frequency of thrombosis and parameters of hemodynamics of left auricle].

Aim: To assess frequency of left auricular thrombosis and effect of long-term therapy with acenocoumarol on auricular hemodynamics and system of hemostasis and to elucidate predictors of effective therapy with acenocoumarol in patients with nonvalvular atrial fibrillation.
Material: Patients (n=100) with nonvalvular atrial fibrillation and at least 1 risk factor of thromboembolic complications.
Methods: Transesophageal echocardiography and measurement of blood D-dimer levels were carried out before and after 1 year of acenocoumarol therapy.
Results: Initial prevalence of left auricular thrombosis was 75%. The use of acenocoumarol for 12 months resulted in significant reduction of frequency of left auricular thrombosis. This was associated with improvement of parameters of intraatrial hemodynamics and lowering of elevated blood D-dimer levels. Clinical-instrumental predictors of presence of left auricular thrombosis and its dynamics during therapy with acenocoumarol were also elucidated.