Raskob G E, Comp P C
University of Oklahoma Health Sciences Center, Oklahoma City.
Cardiol Clin. 1994 Aug;12(3):477-85.
Clinical trial results support the aggressive use of anticoagulant therapy to prevent systemic embolism in patients with acute myocardial infarction who are at high risk for embolism (e.g., anterior transmural infarction). Other patients at risk for systemic embolism include those with chronic left ventricular aneurysm, chronic dilated cardiomyopathy, and cardiac tumors. The role of antithrombotic therapy in these latter groups is incompletely resolved because of a lack of clinical trials. However, in view of the devastating consequences of systemic embolism, the documented effectiveness of antithrombotic therapy in other high-risk patients and the improved safety of long-term anticoagulant treatment in recent years, it may be prudent to use antithrombotic treatment unless contraindicated.
临床试验结果支持积极使用抗凝治疗，以预防急性心肌梗死且有高栓塞风险（如前壁透壁性梗死）患者发生全身性栓塞。其他有全身性栓塞风险的患者包括患有慢性左心室动脉瘤、慢性扩张型心肌病和心脏肿瘤的患者。由于缺乏临床试验，抗栓治疗在这些后一组患者中的作用尚未完全明确。然而，鉴于全身性栓塞的严重后果、抗栓治疗在其他高危患者中已证实的有效性以及近年来长期抗凝治疗安全性的提高，除非有禁忌证，使用抗栓治疗可能是谨慎的做法。
