European Journal of Molecular & Clinical Medicine ISSN 2515-8260 Volume 7, Issue 2, 2020 2346 COMPARATIVE CHARACTERISTICS OF ANTICOAGULANTS AT ATRIAL FIBRILLATION IN COMORBID PATIENTS Botir Daminov, Sherzod Abdullaev, Ranokhon Igamberdieva E-mail: rano1982@yandex.ru Tashkent pediatric medical institute, Tashkent, Uzbekistan Abstract: Patients with Chronic Kidney Disease (CKD) develop a tendency to bleed and thromboembolism, so the indication for anticoagulants at the attachment of atrial fibrillation (AF) is complex. AF is the most common chronic heart arrhythmia, and thromboembolism and ischemic stroke in particular are the main complications. In recent years, new oral anticoagulants have been developed and they have shown superiority over the classic antivitamin K anticoagulants in preventing the risk of stroke, systemic embolism and bleeding, providing an effective alternative to these resources. Keywords: chronic kidney disease, atrial fibrillation, new oral anticoagulants, rivaroxaban, warfarin. In modern craniological practice, atrial fibrillation (AF) is the most common arrhythmia that requires close attention of doctors due to the high risk of thromboembolic complications (TEO). The prevalence of AF in the population is very high and continues to grow [1]. The problem of the prevention of feasibility studies associated with atrial fibrillation remains extremely relevant, as evidenced by the high frequency of strokes, 80% of which are ischemic. Every third patient with a stroke dies, 80% of surviving patients replenish the army of disabled people and only 20% are able to return to work [2, 11]. As you know, ischemic strokes differ in nature. The most common of these is an atherothrombotic stroke (50%). The second place (from 20 to 25%) is occupied by cardioembolic strokes, mainly associated with the formation of blood clots in the cavity of the left atrium with AF. Typically, one in six strokes occurs in a patient with AF [3]. The risk of stroke is present in the patient with both symptomatic and asymptomatic forms of AF. Moreover, it is the same in patients with paroxysmal and persistent AF [4]. That is why, regardless of which tactics of managing a patient with AF will be chosen - restoration of sinus rhythm or control of heart rate, the prevention of thromboembolic events should occupy the first place. Almost every third patient with AF has either an initial or moderately severe stage of chronic kidney disease - this combination increases the risk of stroke by 1.4 times [5, 9]. The terminal stage of chronic kidney disease is also not uncommon among patients with AF. Approximately 20% of patients with chronic kidney disease in the terminal stage have additional AF [6]. And among patients with AF, about 5% have a decrease in glomerular filtration rate below 15 ml / min, which corresponds to the terminal stage of chronic kidney disease - in these patients, the risk of stroke increases many times, reaching a 5-10-fold increase [7]. The problem of treating patients with comorbidity - a combination of AF and renal failure - is that there are few special clinical studies that would focus on the use of oral anticoagulants for the prevention of strokes and thromboembolic complications in this category of patients.