Department of Vascular Medicine and Internal Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
Semin Thromb Hemost. 2009 Sep;35(6):527-42. doi: 10.1055/s-0029-1240013. Epub 2009 Sep 28.
Despite overwhelming evidence of the benefits of risk-adjusted oral anticoagulation on stroke reduction in patients with atrial fibrillation (AF), there is still considerable undertreatment. A multidisciplinary expert group was formed to discuss issues surrounding anticoagulant treatment of patients with AF to try and achieve consensus on various aspects of the implementation of guidelines on oral anticoagulation therapy in AF. Panel members were cardiologists, hematologists, and laboratory and primary care physicians with specific expertise from Europe and the United States. One of the most important conclusions of the meeting was to enhance guideline adherence by better communication of the data showing that the benefits of stroke reduction outweigh the risk of bleeding associated with treatment with vitamin K antagonists. Management of oral anticoagulation therapy by dedicated centers, such as anticoagulation clinics, or by patient self-management may improve the quality of anticoagulation and facilitate the management of these patients and thereby further facilitate optimal antithrombotic management in patients with AF.
尽管有大量证据表明，调整风险的口服抗凝治疗可降低房颤（AF）患者的中风风险，但仍有相当大的治疗不足。一个多学科专家组成立，讨论围绕抗凝治疗 AF 患者的问题，试图在口服抗凝治疗 AF 指南的各个方面达成共识。小组成员包括来自欧洲和美国的心脏病专家、血液学家以及实验室和初级保健医生，具有特定专业知识。会议的一个最重要的结论是，通过更好地沟通数据，增强对指南的遵循，这些数据表明，降低中风的益处大于与维生素 K 拮抗剂治疗相关的出血风险。通过专门的中心（如抗凝诊所）或患者自我管理来管理口服抗凝治疗，可能会提高抗凝质量，便于这些患者的管理，从而进一步促进 AF 患者的最佳抗血栓治疗管理。
