Koudstaal P J
Department of Neurology, University Hospital Rotterdam, 40 Dr Molewaterplein, Rotterdam, Netherlands, 3015 GD.
Cochrane Database Syst Rev. 2000(2):CD000185. doi: 10.1002/14651858.CD000185.
People with nonrheumatic atrial fibrillation who have had a transient ischemic attack or a minor ischemic stroke are at risk of recurrent stroke.
The objective of this review was to assess the effect of anticoagulants for secondary prevention, after a stroke or transient ischaemic attack, in patients with nonrheumatic atrial fibrillation.
The reviewer searched the Cochrane Stroke Group trials register and contacted trialists.
Randomised trials comparing oral anticoagulants (target International Normalised Ratio range 2.5 to 4.0) with control or placebo in people with nonrheumatic atrial fibrillation and a previous transient ischaemic attack or minor ischaemic stroke.
One reviewer assessed trial quality and extracted data.
Two trials involving 485 people were included. Anticoagulants reduced the risk of recurrent stroke by two-thirds (odds ratio 0.36, 95% confidence interval 0.22 to 0.58). The risk of all vascular events was shown to be almost halved by treatment (odds ratio 0.55, 95% confidence interval 0.37 to 0.82). No intracranial bleeds were reported among people given anticoagulants.
REVIEWER'S CONCLUSIONS: The evidence suggests that anticoagulants are beneficial, without serious adverse effects, for people with nonrheumatic atrial fibrillation and recent cerebral ischaemia.
患有非风湿性心房颤动且曾发生短暂性脑缺血发作或轻度缺血性卒中的患者有复发性卒中的风险。
本综述的目的是评估抗凝剂对非风湿性心房颤动患者在卒中或短暂性脑缺血发作后二级预防的效果。
综述作者检索了Cochrane卒中小组试验注册库并联系了试验研究者。
在非风湿性心房颤动且既往有短暂性脑缺血发作或轻度缺血性卒中的患者中，比较口服抗凝剂（目标国际标准化比值范围为2.5至4.0）与对照组或安慰剂的随机试验。
一名综述作者评估试验质量并提取数据。
纳入了两项涉及485人的试验。抗凝剂使复发性卒中风险降低了三分之二（比值比0.36，95%置信区间0.22至0.58）。治疗显示所有血管事件的风险几乎减半（比值比0.55，95%置信区间0.37至0.82）。接受抗凝剂治疗的患者中未报告颅内出血。
证据表明，抗凝剂对非风湿性心房颤动和近期脑缺血患者有益，且无严重不良反应。
