Antoniou Sotiris, Amara Walid
Cardiovascular Medicine, Barts Health NHS Trust, St Bartholomew's Hospital, West Smithfield, London EC1A 7BE, UK.
Unité de Rythmologie, GHI Le Raincy-Montfermeil, 10, Rue du Général-Leclerc, Montfermeil 93370, France.
Eur Heart J Suppl. 2016 Apr 20;18(Suppl D):D7-D15. doi: 10.1093/eurheartj/suv061.
Oral anticoagulation is the long-term standard of care for preventing stroke in patients with atrial fibrillation (AF). However, anticoagulation is associated with an increased risk of bleeding, such that its use should be based on the absolute risks of stroke and bleeding, and the relative benefit-risk profile of the individual patient. Non-vitamin K antagonist oral anticoagulants, including rivaroxaban, are alternatives to vitamin K antagonists such as warfarin in this setting, and are supported in treatment guidelines as the optimal choice for patients with AF at moderate to high risk of stroke. Rivaroxaban can be given in fixed doses without routine coagulation monitoring, and phase III studies have demonstrated its safety profile and efficacy in patients with non-valvular AF, including the elderly and those with co-morbidities. Moreover, rivaroxaban is administered once daily, which has advantages for optimal patient adherence to medication over the long term. The established efficacy and safety profile of rivaroxaban, together with its convenient once-daily dosing schedule, may contribute to improved patient outcomes and lead to sustained benefits for patients with non-valvular AF at risk of stroke.
口服抗凝治疗是预防心房颤动（AF）患者中风的长期标准治疗方法。然而，抗凝治疗会增加出血风险，因此其使用应基于中风和出血的绝对风险以及个体患者的相对获益风险情况。在这种情况下，包括利伐沙班在内的非维生素K拮抗剂口服抗凝药是维生素K拮抗剂（如华法林）的替代药物，并且在治疗指南中被支持作为中风风险为中度至高度的AF患者的最佳选择。利伐沙班可以采用固定剂量给药，无需常规凝血监测，III期研究已证明其在非瓣膜性AF患者（包括老年人和合并症患者）中的安全性和有效性。此外，利伐沙班每日给药一次，从长期来看，这对于患者最佳地坚持用药具有优势。利伐沙班已确立的疗效和安全性，以及其方便的每日一次给药方案，可能有助于改善患者预后，并为有中风风险的非瓣膜性AF患者带来持续的益处。
