Voukalis C, Shantsila E, Lip G Y
GYH Lip, University of Birmingham, Institute of Cardiovascular Sciences, City Hospital, Birmingham B18 7QH, UK. Email:
J R Coll Physicians Edinb. 2017 Mar;47(1):13-23. doi: 10.4997/JRCPE.2017.105.
Oral anticoagulation therapy has reduced the risk of ischaemic stroke and improved the outcomes for patients with atrial fibrillation considerably. The emergence of the non-vitamin K oral anticoagulants as alternatives to vitamin K antagonists has significantly changed the practice of stroke prevention in atrial fibrillation. As the main complication with antithrombotic therapy is bleeding, physicians should always balance the risk of ischaemic stroke against intracranial haemorrhage and intervene where appropriate to reduce both risks. Individual approach is often mandatory due to heterogeneity of the risks and patient preferences. The purpose of this review is to summarise the current knowledge of the oral anticoagulation therapy in atrial fibrillation patients and guide physicians with the management of anticoagulants based on data from clinical trials and systematic reviews.
口服抗凝治疗显著降低了缺血性中风的风险，并改善了心房颤动患者的预后。非维生素K口服抗凝剂作为维生素K拮抗剂的替代药物出现后，极大地改变了心房颤动中风预防的实践。由于抗血栓治疗的主要并发症是出血，医生应始终权衡缺血性中风与颅内出血的风险，并在适当情况下进行干预以降低这两种风险。由于风险的异质性和患者偏好，个体化方法往往是必要的。本综述的目的是总结目前关于心房颤动患者口服抗凝治疗的知识，并根据临床试验和系统评价的数据，指导医生进行抗凝剂管理。
