心房颤动的抗栓治疗
Antithrombotic therapy in atrial fibrillation.
作者信息
Turpie A G, Connolly S J
机构信息
Faculty of Health Sciences, McMaster University, Hamilton, Ont.
出版信息
Can Fam Physician. 1996 Jul;42:1341-5.
OBJECTIVE
To review the evidence for antithrombotic therapy in patients with nonrheumatic atrial fibrillation.
QUALITY OF EVIDENCE
Five primary prevention trials and one secondary prevention trial compare antithrombotic therapy with placebo or no treatment. Two trials also determine the efficacy and safety of acetylsalicylic acid.
MAIN FINDINGS
Warfarin reduces the risk of stroke by 68%. The effect is consistent in all identifiable groups of patients with nonrheumatic atrial fibrillation, except patients at serious risk of hemorrhage. The absolute benefit of anticoagulants varies among patients because of markedly different inherent risk of stroke among patient subgroups.
CONCLUSIONS
Anticoagulant therapy should be considered for all patients with atrial fibrillation. Oral anticoagulant therapy is more effective than ASA in reducing the risk of stroke among patients with nonrheumatic atrial fibrillation.
目的
回顾非风湿性心房颤动患者抗血栓治疗的证据。
证据质量
五项一级预防试验和一项二级预防试验将抗血栓治疗与安慰剂或不治疗进行了比较。两项试验还确定了乙酰水杨酸的疗效和安全性。
主要发现
华法林可将中风风险降低68%。除有严重出血风险的患者外，在所有可识别的非风湿性心房颤动患者组中，该效果均一致。由于患者亚组之间中风的固有风险明显不同，抗凝剂的绝对益处因患者而异。
结论
所有心房颤动患者均应考虑抗凝治疗。在降低非风湿性心房颤动患者中风风险方面，口服抗凝治疗比阿司匹林更有效。
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