Department of Cardiology, Princess Alexandra Hospital, University of Queensland, Brisbane, Australia.
Panminerva Med. 2013 Mar;55(1):43-58.
Stroke attributed to atrial fibrillation (AF) confers significant morbidity and mortality. In the past, warfarin has been the only successful stroke prevention agent available. However, it is often underutilized due to its well-known limitations, leaving many patients without adequate stroke protection. The last decade has seen significant strides forward in the field of anticoagulation for AF. The development of several novel oral anticoagulants that have superior efficacy, improved safety profile and fixed doses without the need for regular monitoring make them favorable as viable alternatives to warfarin. Improved risk scoring systems for both thromboembolism and bleeding have also allowed clinicians to better target patients most likely to benefit from these new therapies. In addition, non-pharmacological approaches to stroke prevention such as left atrial appendage exclusion devices may be useful in patients whom anticoagulation therapy is contraindicated. These new pharmacological and non-pharmacological options for stroke prevention in AF permit clinicians to tailor their management of patients according to individual needs and characteristics. The present review aims to outline the latest up-to-date management of AF in stroke prevention.
归因于心房颤动（AF）的中风会带来重大的发病率和死亡率。过去，华法林是唯一可用的成功预防中风的药物。然而，由于其众所周知的局限性，它经常被低估，导致许多患者没有得到充分的中风保护。在过去的十年中，AF 的抗凝领域取得了重大进展。几种新型口服抗凝剂的疗效更好，安全性更好，固定剂量，无需常规监测，因此作为华法林的可行替代品具有优势。血栓栓塞和出血风险评分系统的改进也使临床医生能够更好地针对最有可能从这些新疗法中受益的患者。此外，非药物预防中风的方法，如左心耳封堵装置，在抗凝治疗禁忌的患者中可能有用。这些 AF 中风预防的新的药理学和非药理学选择使临床医生能够根据患者的个体需求和特征来调整其管理方法。本综述旨在概述 AF 中风预防的最新管理方法。
