心房颤动与慢性心力衰竭的抗凝治疗：风险与首选药物
Anticoagulation in atrial fibrillation and chronic heart failure: the risk and drug of choice.
作者信息
Boos Christopher J, Brown Louise
机构信息
aDepartment of Cardiology, Poole Hospital NHS Foundation Trust, Poole bDepartment of Postgraduate Medical Education, Bournemouth University, Bournemouth, UK.
出版信息
Curr Opin Cardiol. 2016 Mar;31(2):229-34. doi: 10.1097/HCO.0000000000000245.
PURPOSE OF REVIEW
This review seeks to provide an evidence-based update on the issue of atrial fibrillation and chronic heart failure with an emphasis on anticoagulation and the expanding use of the novel oral anticoagulants (NOACs).
RECENT FINDINGS
There is an increasing appreciation of the important reciprocal relationship between atrial fibrillation and heart failure and the negative prognostic impact that each condition has on the other. There are now four NOACs approved for stroke prevention in atrial fibrillation. There are increasing data to support their use in atrial fibrillation with heart failure, including in patients with nonmechanical or rheumatic valvular disease, and to facilitate direct current cardioversion. The choice of NOAC is heavily dependent on individual patient characteristics.
SUMMARY
The use of and indications for NOACs for patients with heart failure and atrial fibrillation are rapidly increasing.
综述目的
本综述旨在提供关于心房颤动与慢性心力衰竭问题的循证更新，重点关注抗凝治疗以及新型口服抗凝药（NOACs）的广泛应用。
最新发现
人们越来越认识到心房颤动与心力衰竭之间重要的相互关系，以及每种疾病对另一种疾病的负面预后影响。目前有四种NOACs被批准用于心房颤动的卒中预防。越来越多的数据支持它们在伴有心力衰竭的心房颤动患者中使用，包括非机械性或风湿性瓣膜病患者，并有助于直流电复律。NOAC的选择很大程度上取决于个体患者特征。
总结
心力衰竭合并心房颤动患者使用NOACs的情况及适应证正在迅速增加。
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