心力衰竭中的心房颤动与血栓预防：采用以患者为中心的方法解决依从性问题的必要性。
Atrial fibrillation and thromboprophylaxis in heart failure: the need for patient-centered approaches to address adherence.
作者信息
Ferguson Caleb, Inglis Sally C, Newton Phillip J, Middleton Sandy, Macdonald Peter S, Davidson Patricia M
机构信息
Center for Cardiovascular and Chronic Care, University of Technology, Sydney, Australia.
出版信息
Vasc Health Risk Manag. 2013;9:3-11. doi: 10.2147/VHRM.S39571. Epub 2013 Jan 16.
Abstract
Atrial fibrillation is a common arrhythmia in heart failure and a risk factor for stroke. Risk assessment tools can assist clinicians with decision making in the allocation of thromboprophylaxis. This review provides an overview of current validated risk assessment tools for atrial fibrillation and emphasizes the importance of tailoring individual risk and the importance of weighing the benefits of treatment. Further, this review provides details of innovative and patient-centered methods for ensuring optimal adherence to prescribed therapy. Prior to initiating oral anticoagulant therapy, a comprehensive risk assessment should include evaluation of associated cardiogeriatric conditions, potential for adherence to prescribed therapy, frailty, and functional and cognitive ability.
摘要
心房颤动是心力衰竭中常见的心律失常，也是中风的危险因素。风险评估工具可协助临床医生在决定是否进行血栓预防时做出决策。本综述概述了当前已验证的心房颤动风险评估工具，并强调了根据个体风险进行调整的重要性以及权衡治疗益处的重要性。此外，本综述还详细介绍了确保最佳依从规定治疗的创新且以患者为中心的方法。在开始口服抗凝治疗之前，全面的风险评估应包括对相关心脏老年病状况、依从规定治疗的可能性、虚弱程度以及功能和认知能力的评估。
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