Cardiovascular Institute, Mount Sinai Medical Center, New York, New York, USA.
J Cardiovasc Electrophysiol. 2011 Aug;22(8):948-55. doi: 10.1111/j.1540-8167.2011.02104.x. Epub 2011 Jun 10.
Atrial fibrillation (AF) is the most common cardiac rhythm disorder and a major risk factor for ischemic stroke. Antithrombotic therapy using vitamin K antagonists (VKA) is currently prescribed for prevention of ischemic stroke in patients with AF. A narrow therapeutic range and frequent food and drug interactions underly the need for regular monitoring of anticoagulation intensity and impairs the utility and safety of VKA, stimulating a quest for alternative anticoagulant agents. Recently developed anticoagulants include the direct thrombin inhibitor, dabigatran, and the factor Xa inhibitors rivaroxaban, apixaban, edoxaban, to name those in the most advanced stages of clinical development. This review focuses on advances in the development of novel antithrombotic agents to provide practical information to clinicians on the use of these new drugs in patients with AF.
心房颤动（AF）是最常见的心律失常，也是缺血性卒中的主要危险因素。目前，使用维生素 K 拮抗剂（VKA）进行抗血栓治疗，用于预防 AF 患者的缺血性卒中。抗凝强度的定期监测是必要的，因为 VKA 的治疗范围较窄，且经常发生食物和药物相互作用，这会影响 VKA 的实用性和安全性，从而刺激了对替代抗凝剂的探索。最近开发的抗凝剂包括直接凝血酶抑制剂达比加群和因子 Xa 抑制剂利伐沙班、阿哌沙班、依度沙班等，这些都是处于临床开发最先进阶段的药物。这篇综述重点介绍了新型抗血栓药物的研发进展，为临床医生在 AF 患者中使用这些新药提供实用信息。
