Singh Mukesh, Adigopula Sasikanth, Patel Pawan, Kiran Kranti, Khosla Sandeep
Department of Cardiology, Mount Sinai Hospital, 1500 California Avenue, Chicago, IL 60608, USA.
Ther Adv Cardiovasc Dis. 2010 Dec;4(6):395-407. doi: 10.1177/1753944710386844. Epub 2010 Oct 21.
Atrial fibrillation is the most common sustained rhythm disturbance. Thromboembolic events related to atrial fibrillation result in significant morbidity, mortality and increases in the cost of healthcare. Anticoagulants are pivotal agents for the prevention and treatment of thromboembolic disorders. The latest American College of Cardiology/American Heart Association guidelines recommend antithrombotic therapy to prevent thromboembolism for all patients with atrial fibrillation, except those with lone atrial fibrillation or contraindications. Vitamin K antagonists were first synthesized in 1948 and for the past six decades they have been the only agents used for long-term oral anticoagulant therapy. Although these drugs are effective, they have numerous limitations, which have led to the development of newer anticoagulant therapies. The emerging oral anticoagulant agents are target selective. They have predictable pharmacokinetic and pharmacodynamic parameters and do not require routine monitoring. They are not associated with significant food and drug interactions, and can be administered in simple fixed daily or twice daily doses. This article reviews the current literature on various targets for anticoagulant therapy and newer oral anticoagulants for atrial fibrillation.
心房颤动是最常见的持续性心律失常。与心房颤动相关的血栓栓塞事件会导致显著的发病率、死亡率，并增加医疗保健成本。抗凝剂是预防和治疗血栓栓塞性疾病的关键药物。美国心脏病学会/美国心脏协会的最新指南建议，除孤立性心房颤动或有禁忌证的患者外，所有心房颤动患者均应接受抗栓治疗以预防血栓栓塞。维生素K拮抗剂于1948年首次合成，在过去的六十年里，它们一直是唯一用于长期口服抗凝治疗的药物。尽管这些药物有效，但它们有许多局限性，这导致了新型抗凝治疗方法的发展。新兴的口服抗凝剂具有靶点选择性。它们具有可预测的药代动力学和药效学参数，不需要常规监测。它们与显著的食物和药物相互作用无关，并且可以以简单的固定每日或每日两次剂量给药。本文综述了目前关于抗凝治疗各种靶点以及用于心房颤动的新型口服抗凝剂的文献。
