{"title":"口服抗凝药物治疗心房颤动的益处和风险","authors":"Vanessa Roldána , Francisco Marín","doi":"10.1016/S1131-3587(19)30029-9","DOIUrl":null,"url":null,"abstract":"<div><p>Atrial fibrillation is associated with high morbidity and mortality, which are principally due to an increased risk of thromboembolism – the risk of stroke and systemic embolism are elevated five-fold. Moreover, strokes secondary to atrial fibrillation are associated with higher mortality, greater dependency and poorer recovery, and there is a high rate of recurrence. Anticoagulant treatment decreases the risk of thrombotic events; compared with placebo, the rate of strokes is reduced by 64% and mortality is reduced by 26%.However, anticoagulant treatment is associated with an increased risk of hemorrhagic complications. In particular, the risk of intracranial hemorrhage, a fatal complication, is increased. The emergence of direct oral anticoagulants has not only improved the efficacy of anticoagulant treatment but, importantly, has also increased its safety. However, as patients do not all have the same thromboembolic and hemorrhagic risks, it is essential that these risks are evaluated in individual patients with atrial fibrillation and that potentially modifiable hemorrhagic risk factors are identified. Finally, it is important that anticoagulant drug treatment is adjusted to suit the individual patient to optimize the benefits of treatment whilesimultaneously reducing the risks.</p><p>Supplement information: this article is part of a supplement entitled “Treatment of patients with atrial fibrillation undergoing percutaneous coronary intervention: an update”, which is sponsored by Boehringer Ingelheim.</p></div>","PeriodicalId":34926,"journal":{"name":"Revista Espanola de Cardiologia Suplementos","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"1","resultStr":"{\"title\":\"Beneficios y riesgos de los anticoagulantes orales en la fibrilación auricular\",\"authors\":\"Vanessa Roldána , Francisco Marín\",\"doi\":\"10.1016/S1131-3587(19)30029-9\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><p>Atrial fibrillation is associated with high morbidity and mortality, which are principally due to an increased risk of thromboembolism – the risk of stroke and systemic embolism are elevated five-fold. Moreover, strokes secondary to atrial fibrillation are associated with higher mortality, greater dependency and poorer recovery, and there is a high rate of recurrence. Anticoagulant treatment decreases the risk of thrombotic events; compared with placebo, the rate of strokes is reduced by 64% and mortality is reduced by 26%.However, anticoagulant treatment is associated with an increased risk of hemorrhagic complications. In particular, the risk of intracranial hemorrhage, a fatal complication, is increased. The emergence of direct oral anticoagulants has not only improved the efficacy of anticoagulant treatment but, importantly, has also increased its safety. However, as patients do not all have the same thromboembolic and hemorrhagic risks, it is essential that these risks are evaluated in individual patients with atrial fibrillation and that potentially modifiable hemorrhagic risk factors are identified. Finally, it is important that anticoagulant drug treatment is adjusted to suit the individual patient to optimize the benefits of treatment whilesimultaneously reducing the risks.</p><p>Supplement information: this article is part of a supplement entitled “Treatment of patients with atrial fibrillation undergoing percutaneous coronary intervention: an update”, which is sponsored by Boehringer Ingelheim.</p></div>\",\"PeriodicalId\":34926,\"journal\":{\"name\":\"Revista Espanola de Cardiologia Suplementos\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2019-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"1\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Revista Espanola de Cardiologia Suplementos\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S1131358719300299\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Revista Espanola de Cardiologia Suplementos","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1131358719300299","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"Medicine","Score":null,"Total":0}
Beneficios y riesgos de los anticoagulantes orales en la fibrilación auricular
Atrial fibrillation is associated with high morbidity and mortality, which are principally due to an increased risk of thromboembolism – the risk of stroke and systemic embolism are elevated five-fold. Moreover, strokes secondary to atrial fibrillation are associated with higher mortality, greater dependency and poorer recovery, and there is a high rate of recurrence. Anticoagulant treatment decreases the risk of thrombotic events; compared with placebo, the rate of strokes is reduced by 64% and mortality is reduced by 26%.However, anticoagulant treatment is associated with an increased risk of hemorrhagic complications. In particular, the risk of intracranial hemorrhage, a fatal complication, is increased. The emergence of direct oral anticoagulants has not only improved the efficacy of anticoagulant treatment but, importantly, has also increased its safety. However, as patients do not all have the same thromboembolic and hemorrhagic risks, it is essential that these risks are evaluated in individual patients with atrial fibrillation and that potentially modifiable hemorrhagic risk factors are identified. Finally, it is important that anticoagulant drug treatment is adjusted to suit the individual patient to optimize the benefits of treatment whilesimultaneously reducing the risks.
Supplement information: this article is part of a supplement entitled “Treatment of patients with atrial fibrillation undergoing percutaneous coronary intervention: an update”, which is sponsored by Boehringer Ingelheim.
期刊介绍:
Revista Española de Cardiología, is an international scientific journal dealing with cardiovascular medicine. Revista Española de Cardiología, the official publication of the Spanish Society of Cardiology, publishes research articles related to cardiovascular diseases. Articles are published in Spanish for the paper edition and in both Spanish and English in the electronic edition, which is available on the Internet. Regular sections include original articles reporting clinical or basic research, brief reports, review articles, editorials and letters to the Editor.