Phillips S J
Department of Medicine (Division of Neurology), Dalhousie University, Halifax, Nova Scotia, Canada.
Can J Neurol Sci. 1990 May;17(2):163-8. doi: 10.1017/s0317167100030390.
That non-rheumatic atrial fibrillation is an independent risk factor for cerebral infarction has not been established with certainty. The rationale underlying contemporary clinical trials of warfarin therapy for the prevention of stroke in patients who have non-rheumatic atrial fibrillation is that the majority of strokes in such patients are due to cardiogenic cerebral embolism. However, there is evidence to suggest that the increased probability of stroke attributed to this arrhythmia is due to its association with other risk factors such as hypertension, diabetes mellitus, and atherosclerosis. The question of who should be anticoagulated is a major public health issue since atrial fibrillation is present in approximately ten per cent of the general population aged 65 or more years.
非风湿性心房颤动是否为脑梗死的独立危险因素尚未明确。当代针对非风湿性心房颤动患者进行华法林预防卒中治疗的临床试验的基本原理是,此类患者中的大多数卒中是由心源性脑栓塞所致。然而,有证据表明,归因于这种心律失常的卒中风险增加是由于其与高血压、糖尿病和动脉粥样硬化等其他危险因素相关。由于在65岁及以上的普通人群中约有10%存在心房颤动,因此哪些人应该接受抗凝治疗的问题是一个重大的公共卫生问题。