用于术后房颤管理的抗凝策略。
Anticoagulation strategies for the management of postoperative atrial fibrillation.
作者信息
Anderson Eric, Dyke Cornelius, Levy Jerrold H
机构信息
Department of Surgery, University of North Dakota School of Medicine and Health Sciences, Grand Forks, 501 North Columbia Road Stop 9037, ND 58103, USA.
Department of Surgery, University of North Dakota School of Medicine and Health Sciences, Grand Forks, 501 North Columbia Road Stop 9037, ND 58103, USA; Department of Cardiothoracic Surgery, Sanford Health Fargo, 801 Broadway North, Fargo, ND 58122, USA.
出版信息
Clin Lab Med. 2014 Sep;34(3):537-61. doi: 10.1016/j.cll.2014.06.012. Epub 2014 Jul 19.
Patients undergoing thoracic and cardiac procedures are at the highest risk for postoperative atrial fibrillation (POAF). POAF is associated with poor short-term and long-term outcomes, including high rates of early and late stroke, and late mortality. Patients with POAF that persists for longer than 48 hours should be anticoagulated on warfarin. Three new oral anticoagulants are available for the treatment of nonvalvular atrial fibrillation and have been found to be as efficacious or superior to warfarin in the prevention of stroke in high-risk patients, with similar to lower rates of major bleeding, and lower rates of intracranial hemorrhage.
接受胸科和心脏手术的患者术后发生房颤（POAF）的风险最高。POAF与短期和长期不良预后相关，包括早期和晚期中风的高发生率以及晚期死亡率。POAF持续超过48小时的患者应使用华法林进行抗凝治疗。有三种新型口服抗凝剂可用于治疗非瓣膜性房颤，并且已发现它们在高危患者预防中风方面与华法林疗效相当或更优，严重出血发生率相似或更低，颅内出血发生率更低。
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