Petersen P
Department of Neurology, University Hospital, Rigshospitalet, Copenhagen, Denmark.
Am J Cardiol. 1990 Feb 2;65(6):24C-28C. doi: 10.1016/0002-9149(90)90111-d.
Atrial fibrillation (AF) is found in 0.4% of adults younger than age 60 years and in 2 to 4% older than age 60 years, and is associated with a high risk of thromboembolic complications. AF--paroxysmal and chronic--has many etiologies, including rheumatic and nonrheumatic heart disease and thyrotoxicosis. Knowing how strokes occur and what precipitates them--e.g., differentiating between cardioembolic and cerebrovascular causes--is important when deciding on appropriate treatment. Risk factors involved in the development of thromboembolic complications associated with AF are reviewed, focusing on the contributions of thyrotoxic AF, paroxysmal AF (and its transition to chronic AF), enlargement of the left atrium, silent cerebral infarction and decreased cerebral blood flow. Data from several studies are briefly presented, highlighting major outcomes. On the basis of current information about prevention of thromboembolic complications, it seems reasonable to recommend anticoagulant treatment for patients with nonrheumatic chronic AF.
在60岁以下的成年人中，房颤（AF）的发病率为0.4%，而在60岁以上的人群中，发病率为2%至4%，且与血栓栓塞并发症的高风险相关。阵发性和慢性房颤有多种病因，包括风湿性和非风湿性心脏病以及甲状腺毒症。在决定适当的治疗方案时，了解中风如何发生以及引发中风的因素——例如，区分心源性栓塞和脑血管病因——非常重要。本文回顾了与房颤相关的血栓栓塞并发症发生发展过程中的危险因素，重点关注甲状腺毒症性房颤、阵发性房颤（及其向慢性房颤的转变）、左心房扩大、无症状性脑梗死和脑血流量减少的影响。简要介绍了几项研究的数据，突出了主要结果。根据目前关于预防血栓栓塞并发症方面的信息，对于非风湿性慢性房颤患者推荐抗凝治疗似乎是合理的。
