Barwon Health, Geelong Hospital, Victoria, Australia.
Heart Lung Circ. 2013 Dec;22(12):1043-7. doi: 10.1016/j.hlc.2013.04.115. Epub 2013 May 28.
Until lately warfarin was the only valuable oral anticoagulant in stroke reduction in high risk cases with non valvular atrial fibrillation (NVAF). Although with warfarin the rate of stroke reduced notably, the major concern is the risk of serious bleeding and difficulty of establishing and maintaining the international normalised ratio (INR) within the therapeutic range. With the development of the novel anticoagulants we now have for the first time since the innovation of Warfarin feasible alternatives to it to decrease stroke rates in high risk patients with NVAF. To diminish adverse bleeding events with the novel anticoagulant proper selection of patients prior starting treatment is essential.
直到最近,华法林仍是非瓣膜性心房颤动(NVAF)高危病例中减少中风的唯一有效口服抗凝剂。虽然华法林显著降低了中风的发生率,但主要问题是严重出血的风险以及难以在治疗范围内建立和维持国际标准化比值(INR)。随着新型抗凝剂的发展,我们现在首次有了自华法林创新以来的可行替代品,可降低 NVAF 高危患者的中风发生率。为了减少新型抗凝剂的不良出血事件,在开始治疗前对患者进行适当的选择是至关重要的。