在心房动中预防中风:系统性审查
Gregory Y H Lip1, Deirdre A Lane2
1University of Birmingham Centre for Cardiovascular Sciences, City Hospital, Birmingham, United Kingdom2Aalborg Thrombosis Research Unit, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
JAMA
|May 20, 2015
概括
口服抗凝药显著降低了心房动 (AF) 中的中风风险. 患有AF和至少一个风险因素的患者应提供口服抗凝药,以有效预防中风.
科学领域:
- 心脏病学 心脏病学
- 神经学 神经学
- 药理学 药理学是指药理学的学科.
背景情况:
- 心房动 (AF) 显著增加死亡率,发病率和中风风险.
- 与AF无关的中风相比,与AF无关的中风导致的死亡率,残疾和长期住院时间都更高.
研究的目的:
- 审查目前的概念和近期的进展,在中风预防的AF患者.
- 提供实际的管理建议,以减少AF中风风险.
主要方法:
- 在2015年3月11日之前,使用MEDLINE进行了全面的文献搜索.
- 研究的重点是心房动,中风,出血风险和预防策略.
主要成果:
- 抗凝药治疗,包括维生素K对抗剂 (VKA) 和非VKA口服抗凝剂 (NOAC),有效降低了AF中风风险.
- 建议口服抗凝药 (OAC) 用于AF患者,其CHA2DS2-VASc得分为1或更高 (不包括仅因性别而得分为1的女性).
- 评估和管理出血风险因素,如控制血压和避免不必要的药物,与OAC治疗一起至关重要.
结论:
- 预防中风是AF管理的关键方面,不管是节拍或节律控制.
- 所有具有一个或多个中风风险因素的AF患者都应考虑服用口服抗凝剂治疗.
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