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[共识声明:特殊考虑新型直接口服抗凝剂时非瓣膜性心房颤动的卒中预防]

[Consensus statement: Stroke prevention in nonvalvular atrial fibrillation in special consideration of the new direct oral anticoagulants].

作者信息

Pabinger Ingrid, Lang Wilfried, Roithinger Franz Xaver, Weidinger Franz, Eichinger-Hasenauer Sabine, Glehr Reinhold, Halbmayer Walter-Michael, Haring Hans-Peter, Jilma Bernd, Korninger Hans Christian, Kozek-Langenecker Sibylle, Kyrle Paul, Watzke Herbert, Weltermann Ansgar, Willeit Johann, Huber Kurt

机构信息

Klin. Abt. für Hämatologie u. Hämostaseologie, Univ.-Klin. f. Innere Medizin I, MedUni Wien, Währinger Gürtel 18-20, 1090, Wien, Österreich,

出版信息

Wien Klin Wochenschr. 2014 Dec;126(23-24):792-808. doi: 10.1007/s00508-014-0586-5. Epub 2014 Oct 3.

Abstract

The introduction of new direct oral anticoagulants has changed the treatment of nonvalvular atrial fibrillation. However, these changes are not yet fully reflected in current guidelines.This consensus statement, endorsed by six Austrian medical societies, provides guidance to current prophylactic approaches of thromboembolic events in nonvalvular atrial fibrillation on the basis of current evidence and published guidelines. Furthermore, some special subjects are treated, like changes in laboratory parameters and their interpretation under treatment with direct oral anticoagulants, treatment of bleedings, approach to operations, cardioversion and ablation, and specific neurological aspects. For a CHA2DS2-VASc-Score of ≥ 2, anticoagulation is recommended with a high level of evidence (1A). At the end of the consensus statement, recommendations for a number of specific patient subgroups can be found, in order to help treating physicians to arrive at appropriate therapeutic decisions.

摘要

新型直接口服抗凝剂的引入改变了非瓣膜性心房颤动的治疗方式。然而,这些变化尚未在当前指南中得到充分体现。本共识声明得到了六个奥地利医学协会的认可,它基于当前证据和已发表的指南,为非瓣膜性心房颤动血栓栓塞事件的当前预防方法提供指导。此外,还探讨了一些特殊主题,如直接口服抗凝剂治疗下实验室参数的变化及其解读、出血的治疗、手术方法、心脏复律和消融以及特定的神经学方面。对于CHA2DS2-VASc评分≥2的患者,推荐进行抗凝治疗,证据等级为高(1A)。在共识声明的结尾,可以找到针对一些特定患者亚组的建议,以帮助治疗医生做出合适的治疗决策。

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