尽管服用口服抗凝药,心房动和缺血性中风仍然存在
Roberto Galea1, David Seiffge2, Lorenz Räber1
1Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, 3010 Bern, Switzerland.
Journal of clinical medicine
|September 28, 2023
概括
在接受口服抗凝剂 (OAC) 的心房患者中突破性中风很常见,并具有很高的风险. 了解OAC失效机制是有效的二次中风预防策略的关键.
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:
- 接受口服抗凝药 (OAC) 的心房动 (AF) 患者可能会经历突破性缺血性中风.
- 这些事件意味着复发性中风和死亡率的高风险.
- 了解OAC故障机制对于有针对性的二次预防至关重要.
研究的目的:
- 审查AF患者OAC衰竭的发病率,临床影响和机制.
- 在这个高风险群体中讨论第二次中风预防的治疗选择.
- 探索未来的研究方向.
主要方法:
- 文献综述侧重于AF患者的OAC衰竭.
- 对OAC失败背后潜在机制的分析.
- 对二次中风预防策略的证据评估.
主要成果:
- 在OAC的AF患者中突破性中风并不罕见,这构成了重大的临床挑战.
- OAC失效的机制是异质的,并未完全理解.
- 目前的指导方针缺乏针对这些患者的二次中风预防的具体建议.
结论:
- 在AF突破性中风患者中有效的二次中风预防仍然是一个临床困境,因为数据有限.
- 治疗选择包括OAC修改,抗血小板治疗或左心房附属体关闭.
- 需要进一步的研究来指导最佳的管理策略.
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