Novaković Anucin Sladana, Gnip Sanja, Canak Visnja, Radović Pavica, Kovacev Jelena, Mitić Gorana
Klinicki centar Vojvodine, Novi Sad Centar za laboratorijsku medicinu.
Med Pregl. 2013 Nov-Dec;66(11-12):470-5. doi: 10.2298/mpns1312470n.
Atrial fibrillation increases the risk of ischemic stroke five fold, while the application of long-term anticoagulant therapy is associated with the occurrence of hemorrhagic complications. The aim of our study was to evaluate the incidence of thrombotic and hemorrhagic complications in patients with atrial fibrillation during antithrombotic treatment.
The study included 504 patients that were administered the primary (n=345) or secondary thromboprophylaxis after ischemic stroke (n=159), by applying vitamin K antagonists, or the combination of vitamin K antagonists and low-dose aspirin. The patients were followed for five months in the period of 24 years from 1988 to 2012, the total number of patient's years being 1884, at the Clinical Center of Vojvodina Thromboembolic and hemorrhagic complications were registered during regular check-up examinations.
Our results indicate the low incidence of thromboembolic complications (0.01 patient per a year), with a lower incidence in the vitamin K antagonists group than in the group with the combination of vitamin K antagonists and aspirin (0.008 patient per a year versus 0.01 patient per a year). The incidence of hemorrhagic complications was higher in the group with the combined treatment compared to the group treated with vitamin K antagonists (0.1 patient per a year versus 0.06 patient per a year). The frequency of major bleeding was as low as 0.01 patient per a year and more frequent in the group with combined treatment (0.03 patient per a year).
The overall incidence of complications in the study group was 0.08 patient per a year. The combined antithrombotic treatment increases the risk of hemorrhagic complications and affects the severity of bleeding. Oral anticoagulant therapy is more efficient in the prevention of ischemic stroke and thromboembolic complications in patients with atrial fibrillation.
心房颤动使缺血性卒中风险增加五倍，而长期应用抗凝治疗会引发出血并发症。我们研究的目的是评估心房颤动患者在抗栓治疗期间血栓形成和出血并发症的发生率。
本研究纳入504例患者，这些患者在缺血性卒中后接受一级（n = 345）或二级血栓预防（n = 159），应用维生素K拮抗剂，或维生素K拮抗剂与小剂量阿司匹林联合使用。在1988年至2012年的24年期间，对患者进行了5个月的随访，患者总人年数为1884，在伏伊伏丁那临床中心定期检查期间记录血栓栓塞和出血并发症。
我们的结果表明血栓栓塞并发症发生率较低（每年0.01例患者），维生素K拮抗剂组的发生率低于维生素K拮抗剂与阿司匹林联合使用组（每年0.008例患者对每年0.01例患者）。联合治疗组的出血并发症发生率高于维生素K拮抗剂治疗组（每年0.1例患者对每年0.06例患者）。严重出血的频率低至每年0.01例患者，联合治疗组更常见（每年0.03例患者）。
研究组并发症的总体发生率为每年0.08例患者。联合抗栓治疗增加了出血并发症的风险并影响出血的严重程度。口服抗凝治疗在预防心房颤动患者的缺血性卒中和血栓栓塞并发症方面更有效。
