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用于心房颤动卒中预防的新型抗凝剂:综述

Novel Anticoagulants for Stroke Prevention in Atrial Fibrillation: A Comprehensive Review.

作者信息

Perswani Prinka, Yogarajah Ritesh Croos, Saifuddin Mohammed, Lakhani Alisha, Dasi Jagruti, Bhardwaj Vanshika, Kumar Bhavana, Raina Ojasvi, Fletcher Nicole, Jomy Grace, Iyer Pracruti, Pasi Jai, Tayal Kanika, Reza Hasim

机构信息

Internal Medicine, Liaquat University of Medical and Health Sciences, Jamshoro, PAK.

Cardiology, Jonelta Foundation School of Medicine, University of Perpetual Help System DALTA, Las Piñas, PHL.

出版信息

Cureus. 2024 Jul 25;16(7):e65347. doi: 10.7759/cureus.65347. eCollection 2024 Jul.

Abstract

Atrial fibrillation (AF) is a prevalent cardiac arrhythmia associated with an increased risk of stroke due to disrupted heart function and potential clot formation. This review examines current management strategies for stroke prevention in AF, focusing on the efficacy, safety, and long-term outcomes of anticoagulation therapies. Anticoagulants, including novel oral anticoagulants (NOACs) and vitamin K antagonists, play a crucial role in reducing stroke risk by preventing clot formation in the heart. Recent studies highlight NOACs as superior alternatives to traditional therapies, offering improved safety profiles and enhanced patient adherence. Despite the risk of bleeding complications, judicious use of anticoagulants significantly improves clinical outcomes in AF patients. The review synthesizes evidence from clinical trials and meta-analyses to underscore the pivotal role of NOACs in transforming stroke prevention strategies in AF. Moreover, it discusses emerging interventions such as left atrial appendage occlusion and emphasizes the importance of personalized, patient-centered care in optimizing treatment decisions for AF patients at risk of stroke.

摘要

心房颤动(AF)是一种常见的心律失常,由于心脏功能紊乱和潜在的血栓形成,其与中风风险增加相关。本综述探讨了目前房颤患者预防中风的管理策略,重点关注抗凝治疗的疗效、安全性和长期结果。抗凝剂,包括新型口服抗凝剂(NOACs)和维生素K拮抗剂,通过防止心脏内血栓形成,在降低中风风险方面发挥着关键作用。最近的研究强调,NOACs是传统疗法的 superior alternatives,具有更好的安全性和更高的患者依从性。尽管存在出血并发症的风险,但谨慎使用抗凝剂可显著改善房颤患者的临床结果。该综述综合了临床试验和荟萃分析的证据,以强调NOACs在改变房颤中风预防策略中的关键作用。此外,它还讨论了诸如左心耳封堵等新兴干预措施,并强调了个性化、以患者为中心的护理在优化有中风风险的房颤患者治疗决策中的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/221e/11344489/c9d3bcc09d62/cureus-0016-00000065347-i01.jpg

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