在心房动中预防中风:展望未来
Aristeidis H Katsanos1, Hooman Kamel2, Jeff S Healey3
1Division of Neurology, McMaster University and Population Health Research Institute, Hamilton Health Sciences, Canada (A.H.K., R.G.H.).
Circulation
|December 14, 2020
概括
在心房中风预防方面的进展包括更安全的抗凝剂和新的治疗方法,如左心房塞. 正在进行的研究探讨了最佳时间,出血风险以及预防心血管梗塞的新疗法.
科学领域:
- 心脏病学
- 神经学
- 药理学
背景情况:
- 前庭动是缺血性中风的主要原因,导致严重的神经缺陷和高复发率.
- 尽管取得了进展,但AF患者中风复发和抗凝血治疗的长期风险仍然存在.
- 目前的预防策略需要不断改进以平衡有效性和安全性.
研究的目的:
- 审查过去30年中心患者中风预防方面的重大进展.
- 突出目前正在临床试验中的新诊断和治疗方法.
- 讨论AF中心血管栓塞性中风的二次预防新兴疗法.
主要方法:
- 对心房动预防中风的重大进展进行回顾.
- 专注于正在进行的新诊断和治疗方法的临床试验.
- 对非维生素K对抗剂口服抗凝剂 (NOACs) 和左心房塞 (LAAO) 的现有证据的分析.
主要成果:
- 非维生素K对抗性口服抗凝剂 (NOACs) 比华法林更安全,同样有效地预防非膜性风.
- 目前正在研究与风湿性心脏病相关的AF,源不明的中风,以及预防认知衰退.
- 左心房塞 (LAAO) 正在评估初级和二级中风预防,特别是在高出血风险的患者中.
结论:
- 在AF中,NOACs比华法林在中风预防方面显著改善.
- 新兴的策略,如LAAO和新型药物药物 (素,XIa因子抑制剂) 提供未来的治疗途径.
- 目前正在进行密集的研究,以优化AF中风的预防,包括监测,早期检测和量身定制的治疗.
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