Ranasinghe Tamra, Gurol Mahmut Edip
Department of Neurology, Wake Forest School of Medicine, 1 Medical Center Boulevard, Winston-Salem, NC 27157, USA.
Department of Neurology, Massachusetts General Hospital, Harvard Medical School, 175 Cambridge Street, Suite 300, Boston, MA 02114, USA.
Card Electrophysiol Clin. 2023 Jun;15(2):111-117. doi: 10.1016/j.ccep.2023.01.003.
A comprehensive evaluation is necessary to identify the etiologic factors in order to select optimal stroke-prevention measures. Atrial fibrillation is one of the most important stroke causes. Although anticoagulant therapy is the treatment of choice for patients with nonvalvular atrial fibrillation, it should not be considered uniformly to treat all patients given the high mortality associated with anticoagulant-related hemorrhages. The authors propose a risk-stratified individualized approach for stroke prevention in patients with nonvalvular atrial fibrillation by considering nonpharmacologic approaches for patients at high hemorrhage risk or otherwise unsuitable for lifelong anticoagulation.
为了确定病因因素以便选择最佳的中风预防措施,进行全面评估是必要的。心房颤动是最重要的中风病因之一。虽然抗凝治疗是非瓣膜性心房颤动患者的首选治疗方法,但鉴于与抗凝相关出血相关的高死亡率,不应一概而论地考虑对所有患者进行治疗。作者提出了一种风险分层的个体化方法,通过考虑对高出血风险或其他不适合终身抗凝的患者采用非药物方法,来预防非瓣膜性心房颤动患者的中风。