用于预防心房动中风的口服抗凝剂:当前状态,特殊情况和未满足的需求

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Freek W A Verheugt¹, Christopher B Granger²

¹Onze Lieve Vrouwe Gasthuis, Amsterdam, Netherlands.

Lancet (London, England)

|March 18, 2015

概括

与华法林相比,新型非维生素K对抗剂口服抗凝剂 (NOACs) 在心房中提供有效的中风预防,安全性和易用性得到改善. 这篇综述涵盖了它们的作用,特殊情况和相互作用.

科学领域:

心脏病学心脏病学
药理学药理学是指药理学的学科.
内部医学内部医学

背景情况:

维生素K抗体 (VKA) 降低了心房中风的风险,但有诸如出血和监测需求等局限性.
由于这些局限性,VKA的使用不足于最佳水平,只有半数符合条件的患者接受治疗.
新型非维生素K对手口服抗凝剂 (NOACs) 向血栓 (因子IIa) 或因子Xa,为VKA提供替代品.

研究的目的:

在NOACs时代审查抗凝剂在心房动中预防中风的作用.
讨论NOAC在特殊患者群体和临床场景中的使用.
为了处理出血的管理,术前抗凝剂,以及与NOACs的药物相互作用.

主要方法:

临床试验和指导方针建议的NOAC在心房的综述.
与华法林相比,NOAC的有效性和安全性的讨论.
在特定的患者群体和临床情况下探索NOAC的使用.

主要成果:

在心房动中,NOAC与华法林同样有效预防中风.
与华法林相比,NOACs表现出优越的安全概况,所有原因的死亡率明显降低.
NOACs提供易于使用,快速起作用/起作用,但目前缺乏特定的抗药.

结论:

由于其有效性,安全性和易用性,NOACs被推用于心房动中风预防.
在特殊情况下对NOAC的管理策略至关重要,包括出血和程序.
为了最佳的NOAC利用和相互作用的管理,需要进一步的研究和临床指导.

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