Moser M, Bode C
Universitätsklinik Freiburg, Innere Medizin III (Kardiologie und Angiologie), Freiburg.
Hamostaseologie. 2012;32(1):37-9. doi: 10.5482/ha-1186. Epub 2011 Nov 29.
Atrial fibrillation is one of the most frequent reasons for therapeutic anticoagulation in everyday practice. Oral vitamin K antagonists such as Marcumar have been state of the art anticoagulants to prevent thrombembolic events in patients with atrial fibrillation and additional risk factors. But these drugs are accompanied by disadvantages such as increased bleeding risk and impaired quality of life caused by interactions with food or other medications as well as frequent controls of INRs. The new anticoagulants apixaban, rivaroxaban and dabigatran are direct antagonists of coagulation factors (FXa or FIIa) and demonstrate a promising risk/benefit profile in large clinical trials compared with vitamin K antagonists. Their approval for clinical use will open up new therapeutic perspectives for patients with atrial fibrillation and indication for anticoagulation.
在日常医疗实践中，心房颤动是进行治疗性抗凝的最常见原因之一。口服维生素K拮抗剂（如苯丙香豆素）一直是预防伴有其他危险因素的心房颤动患者发生血栓栓塞事件的常用抗凝药物。但这些药物存在一些缺点，如出血风险增加、因与食物或其他药物相互作用导致生活质量受损以及需要频繁监测国际标准化比值（INR）。新型抗凝药物阿哌沙班、利伐沙班和达比加群是凝血因子（FXa或FIIa）的直接拮抗剂，与维生素K拮抗剂相比，在大型临床试验中显示出良好的风险/效益比。它们被批准用于临床将为心房颤动患者及抗凝适应证开辟新的治疗前景。
