Dzeshka Mikhail S, Lip Gregory Y H
University of Birmingham Centre for Cardiovascular Sciences, City Hospital, Birmingham B18 7QH, UK; Grodno State Medical University, Grodno, Belarus.
University of Birmingham Centre for Cardiovascular Sciences, City Hospital, Birmingham B18 7QH, UK.
Cardiol Clin. 2014 Nov;32(4):585-99. doi: 10.1016/j.ccl.2014.07.009. Epub 2014 Sep 2.
As atrial fibrillation (AF) substantially increases the risk of stroke and other thromboembolic events, most AF patients require appropriate antithrombotic prophylaxis. Oral anticoagulation (OAC) with either dose-adjusted vitamin K antagonists (VKAs) (eg, warfarin) or non-VKA oral anticoagulants (eg, dabigatran, apixaban, rivaroxaban) can be used for this purpose unless contraindicated. Therefore, risk assessment of stroke and bleeding is an obligatory part of AF management, and risk has to be weighed individually. Antiplatelet drugs (eg, aspirin and clopidogrel) are inferior to OAC, both alone and in combination, with a comparable risk of bleeding events.
由于心房颤动（AF）会大幅增加中风和其他血栓栓塞事件的风险，大多数AF患者需要进行适当的抗血栓预防。除非有禁忌证，可使用剂量调整的维生素K拮抗剂（VKA）（如华法林）或非VKA口服抗凝剂（如达比加群、阿哌沙班、利伐沙班）进行口服抗凝（OAC）以达到此目的。因此，中风和出血的风险评估是AF管理的必要组成部分，必须对风险进行个体权衡。抗血小板药物（如阿司匹林和氯吡格雷）单独使用或联合使用时均不如OAC，且出血事件风险相当。
