Petersen P, Boysen G, Godtfredsen J
Rigshospitalet, København, neuromedicinsk afdeling.
Ugeskr Laeger. 1991 Jul 22;153(30):2105-7.
Chronic non-rheumatic atrial fibrillation is associated with a risk of thromboembolic complications of about 5% per year. Previous myocardial infarction seems to be a significant risk factor for development of thromboembolic complications in chronic atrial fibrillation, whereas paroxysmal atrial fibrillation and isolated atrial fibrillation in younger patients may be associated with a lower risk of emboli. Silent cerebral infarction occurs more often in chronic atrial fibrillation than among controls in sinus rhythm. Three prospective trials of patients with atrial fibrillation found effect of warfarin on the occurrence of thromboembolic complications. In one study aspirin 325 mg daily was effective in patients below 75 years of age, but not in patients above this age. The other trials revealed no effect of aspirin.
慢性非风湿性心房颤动每年发生血栓栓塞并发症的风险约为5%。既往心肌梗死似乎是慢性心房颤动发生血栓栓塞并发症的一个重要危险因素,而阵发性心房颤动以及年轻患者的孤立性心房颤动发生栓塞的风险可能较低。与窦性心律的对照组相比,无症状性脑梗死在慢性心房颤动患者中更为常见。三项针对心房颤动患者的前瞻性试验发现了华法林对血栓栓塞并发症发生情况的影响。在一项研究中,每日服用325毫克阿司匹林对75岁以下患者有效,但对75岁以上患者无效。其他试验未发现阿司匹林有效果。