患有心房的患者中风:流行病学,查和预后
Olli Pekka Suomalainen1, Nicolas Martinez-Majander1, Jenna Broman1
1Departments of Neurology, Helsinki University Hospital, University of Helsinki, Haartmaninkatu 4, P.O. Box 340, 00290 Helsinki, Finland.
Journal of clinical medicine
|January 11, 2024
概括
在密码性缺血性中风 (CIS) 患者中,对心房动 (AF) 的查对于预防复发性中风至关重要. 早期检测和用直接口服抗凝剂 (DOAC) 治疗可以改善结果.
科学领域:
- 心脏病学 心脏病学
- 神经学 神经学
- 医疗技术 医疗技术 医学技术
背景情况:
- 前庭动 (AF) 是缺血性中风 (IS) 的主要原因,通常导致更严重的事件和更差的结果.
- 心血管栓塞占IS病例的20%以上;有效的抗凝血药物显著降低了未来中风的风险.
- 密码性IS (CIS) 和源不明的栓塞性中风 (ESUS) 通常具有潜在的AF病因,需要彻底查.
研究的目的:
- 审查有关中风患者AF流行病学,查方法和预后的当前知识.
- 强调AF查在CIS和ESUS患者中对于二次中风预防的重要性.
- 讨论抗凝血剂和新型干预措施在管理AF相关中风中的演变作用.
主要方法:
- 审查目前的指导方针和近期随机对照试验 (RCT) 关于AF查和治疗.
- 讨论各种查方式,从短期监测到长期植入器械.
- 探索人工智能 (AI) 方面的进展,以提高AF检测效率.
主要成果:
- 在中风后的更长时间和更早的查增加了检测AF发作的可能性.
- 在AF患者的IS预防中,直接口服抗凝剂 (DOAC) 优先于维生素K抗剂.
- 在急性IS后早期启动DOAC是安全有效的;左心房尾关闭是一个新兴的替代方案.
结论:
- 在CIS/ESUS患者的系统性AF查对于有效的二次中风预防至关重要.
- 目前的指导方针建议延长查时间,并继续研究最佳策略.
- DOAC和潜在的左心房尾关闭为AF相关的中风提供了改进的管理选择.
相关概念视频
01:28Disturbances in Heart Rhythm
961
Arrhythmia or dysrhythmia refers to an abnormal heart rhythm caused by a defect in the heart's conduction system. It can cause the heart to beat irregularly, too quickly, or too slowly, leading to symptoms like chest pain, shortness of breath, and fainting. Factors such as stress, caffeine, alcohol, nicotine, cocaine, certain drugs, congenital defects, diseases, and electrolyte abnormalities can trigger arrhythmias.
Arrhythmias are categorized by their speed, rhythm, and origin. A slow...
Arrhythmias are categorized by their speed, rhythm, and origin. A slow...
961
01:30Anticoagulant Drugs: Low-Molecular-Weight Heparins
701
Hemostasis is a crucial process that prevents excessive blood loss from damaged blood vessels. It involves various mechanisms such as vasoconstriction, platelet adhesion and activation, and fibrin formation. The importance of each mechanism depends on the type of vessel injury. In contrast, thrombosis is the abnormal formation of a blood clot within the blood vessels, leading to potential complications if the clot obstructs blood flow. Thrombosis can be caused by increased coagulability of the...
701