Palomeras E, Roquer J, Pou A
Servicio de Neurología, Hospital del Mar, Barcelona, España.
Rev Neurol. 1998 Nov;27(159):772-6.
Although the indications for oral anticoagulation (AO) in the treatment of cerebral vascular disease (CVD) are well established, their potential side effects continue to give cause for worry.
To describe the complications and ischemic relapses in patients treated with AO for secondary prevention of CVD of cardiac embolic origin.
We included 169 patients with embologenic cardiopathy who, following an CVD, were treated with AO and followed-up at our medical centre for at least three months. We recorded their past clinical history and risk factors, occurrence of vascular relapses (VR), complications involving hemorrhage (CH), and data regarding course and follow-up.
During an average follow-up of 50.3 months of a total of 707.9 patient/years, 20 VR (2.8% per year) were recorded; 15 of these were cerebro-vascular and mainly mild. We recorded 59 CH in 41 patients (8.3% per year) of which 6 were considered to be major. There was a 30% drop-out rate from follow-up at our centre, mainly due to death from other causes or to change of referral centre.
There is a low incidence of relapse and of complications (usually mild) following AO for the secondary prevention of CVD of cardio-embolic origin. Efficacy and security are maintained in the long term.
尽管口服抗凝药（AO）在治疗脑血管疾病（CVD）中的应用指征已明确，但它们潜在的副作用仍令人担忧。
描述接受AO治疗以二级预防心脏栓塞性起源CVD的患者的并发症和缺血性复发情况。
我们纳入了169例栓塞性心脏病患者，这些患者在发生CVD后接受了AO治疗，并在我们的医疗中心随访至少3个月。我们记录了他们过去的临床病史和危险因素、血管复发（VR）的发生情况、出血相关并发症（CH）以及病程和随访数据。
在总共707.9患者年的平均50.3个月随访期间，记录到20次VR（每年2.8%）；其中15次为脑血管复发，且主要为轻度。我们在41例患者中记录到59次CH（每年8.3%），其中6次被认为是严重的。我们中心的随访失访率为30%，主要原因是死于其他原因或转诊至其他中心。
对于心脏栓塞性起源CVD的二级预防，AO治疗后复发和并发症（通常为轻度）的发生率较低。长期来看，疗效和安全性得以维持。
