Division of Cardiology, Department of Medicine, McMaster University, Hamilton General Hospital, 237 Barton Street East, Hamilton, Ontario L8L 2X2, Canada.
Division of Cardiology, Department of Medicine, McMaster University, Hamilton General Hospital, 237 Barton Street East, Hamilton, Ontario L8L 2X2, Canada.
Med Clin North Am. 2019 Sep;103(5):847-862. doi: 10.1016/j.mcna.2019.05.006.
Oral anticoagulation significantly reduces the risk of stroke in patients with atrial fibrillation (AF), and the decision to initiate therapy is based on assessing the patient's yearly risk of stroke. Although warfarin remains the drug of choice in patients with AF and artificial mechanical valves, the novel anticoagulation agents are becoming the drug of choice for all other patients with AF, because of their efficacy, safety, and ease of use. This article summarizes the current evidence for stroke prevention in AF, including valvular AF, subclinical AF, AF in patients with renal insufficiency, as well as stroke prevention around AF cardioversion.
口服抗凝剂可显著降低心房颤动（AF）患者发生中风的风险，治疗决策基于评估患者每年发生中风的风险。尽管华法林仍然是 AF 和人工机械瓣膜患者的首选药物，但新型抗凝药物因其疗效、安全性和易用性，正在成为所有其他 AF 患者的首选药物。本文总结了 AF 患者中风预防的现有证据，包括瓣膜性 AF、亚临床 AF、肾功能不全患者的 AF 以及 AF 转复前后的中风预防。
