新型口服抗凝药物的现状和未来作用——除房颤以外的适应证。
The current and future role of the novel oral anticoagulants--indications beyond atrial fibrillation.
机构信息
Liverpool Hospital, Sydney, Australia; Campbelltown Hospital, Sydney, Australia.
Liverpool Hospital, Sydney, Australia; Campbelltown Hospital, Sydney, Australia; The University of Western Sydney, Sydney, Australia; The University of New South Wales, Sydney, Australia.
出版信息
Heart Lung Circ. 2014 Jan;23(1):2-9. doi: 10.1016/j.hlc.2013.09.007. Epub 2013 Oct 9.
The direct thrombin inhibitors and Factor-Xa inhibitors are novel oral anticoagulants which are gaining rapid acceptance not only as alternatives to warfarin, but also as recommended first line agents for use as stroke prophylaxis in patients with non-valvular atrial fibrillation. There are, however, other patient settings in which anticoagulation is either indicated or has a potential role. Warfarin is still the predominant anticoagulant used for the treatment and prevention of venous thromboembolic events including deep vein thrombosis and pulmonary embolism as well as in patients with mechanical prosthetic heart valves. In this article, we review the current evidence for the use of dabigatran, rivaroxaban, apixaban and edoxaban in these settings. A summary of suggested regimens utilising these agents is provided. Importantly, in addition, attention is also drawn to clinical scenarios in which use of such agents is considered inappropriate.
直接凝血酶抑制剂和因子 Xa 抑制剂是新型口服抗凝剂，它们不仅作为华法林的替代药物迅速得到认可，而且还被推荐作为非瓣膜性心房颤动患者中风预防的一线药物。然而，在其他一些情况下，抗凝治疗也是有指征的，或者具有潜在的作用。华法林仍然是用于治疗和预防静脉血栓栓塞事件（包括深静脉血栓形成和肺栓塞）以及机械人工心脏瓣膜患者的主要抗凝药物。在本文中，我们回顾了达比加群、利伐沙班、阿哌沙班和依度沙班在这些情况下的使用证据。提供了使用这些药物的建议方案摘要。重要的是，此外，还注意到了在某些临床情况下，不考虑使用这些药物的情况。
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