Karapedi Eleni, Papadopoulos Nikolaos, Trifylli Eleni-Myrto, Koustas Evangelos, Deutsch Melanie, Aloizos Georgios
1Department of Internal Medicine, 417 Army Share Fund Hospital (Eleni Karapedi, Nikolaos Papadopoulos, Eleni-Myrto Trifylli, Evangelos Koustas, Georgios Aloizos).
2Academic Department of Internal Medicine, Medical School of National and Kapodistrian University of Athens, Hippokration General Hospital (Melanie Deutsch), Athens, Greece.
Ann Gastroenterol. 2022 Nov-Dec;35(6):557-567. doi: 10.20524/aog.2022.0745. Epub 2022 Oct 3.
Atrial fibrillation (AF) is an increasingly recognized comorbidity in patients with liver cirrhosis, mainly associated with nonalcoholic fatty liver disease and alcohol-associated liver disease, affecting the quality of life and prognosis. On the other hand, cirrhosis is associated with an elevated risk of both thrombosis and bleeding, making the decision about anticoagulation therapy very challenging. Direct-acting oral anticoagulants (DOACs) are approved for patients with non-valvular AF. However, there is limited clinical experience and scientific evidence about their efficacy and safety in liver cirrhosis. This review article investigates the published literature concerning the administration of DOACs and traditional antithrombotic agents, such as vitamin K antagonists and heparins, in patients with liver cirrhosis and AF.
心房颤动（AF）在肝硬化患者中是一种越来越被认识到的合并症，主要与非酒精性脂肪性肝病和酒精相关性肝病相关，影响生活质量和预后。另一方面，肝硬化与血栓形成和出血风险升高相关，这使得抗凝治疗的决策极具挑战性。直接口服抗凝剂（DOACs）已被批准用于非瓣膜性AF患者。然而，关于其在肝硬化患者中的疗效和安全性的临床经验和科学证据有限。这篇综述文章调查了已发表的有关在肝硬化合并AF患者中使用DOACs以及传统抗血栓药物（如维生素K拮抗剂和肝素）的文献。
