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m********4
发帖数: 607 | 1 感谢本版版主的支持，已把200WB转到本版。
版面繁荣，健康建设与发展，需要我们共同的参与。
众人拾柴，火焰高。
族群强大，个人利。 | A*******s
发帖数: 9638 | | m********4
发帖数: 607 | 3 Afib is one of major risk factors to cause stroke. It is common to see pts
with afib in both hospital and clinic. How to manage pts with afib w/o
stroke?
*Thank eastlake to contribute Anticoagulation question.
http://www.mitbbs.com/article_t/Medicalpractice/31165.html
I would recommend the following paper to read.
* A new landscape for stroke prevention in atrial fibrillation: focus on new
anticoagulants, antiarrhythmic drugs, and devices.
Stroke. 2011 Nov;42(11):3316-22. Epub 2011 Oct 13.
Abstract
BACKGROUND:
Worldwide, atrial fibrillation is the most common arrhythmia, and its
symptoms and sequelae cause an enormous burden to patients and health
systems. Stroke is associated with the greatest mortality and morbidity in
patients with atrial fibrillation (AF). The last decade has seen great
advances in scientific and therapeutic approaches to AF.
PURPOSE:
This review considers recent changes to stroke prevention, particularly
focusing on new anticoagulants, antiarrhythmic drugs, and devices as well as
future research directions.
SUMMARY OF REVIEW:
A semi-systematic literature review was performed using search terms "atrial
fibrillation" and "novel therapy" within the PubMed database from 2005 to
2011. The area of greatest progress has been novel anticoagulants with
direct thrombin inhibitors and factor Xa inhibitors. Dabigatran is the only
novel agent currently licensed for use in AF patients, but with several
trials of novel agents pending and favorable results so far, other agents
are likely to follow. Novel antiarrhythmic drugs, left atrial appendage
occlusion, and upstream therapies all represent potential new approaches but
require further research.
CONCLUSIONS:
Novel anticoagulant and arrhythmic agents are changing treatment guidelines
and choices available to both patients and clinicians for stroke prevention
in AF, but bring new considerations and long-term data are required, because
most patients will require lifelong therapy. Future research must
incorporate patient values and preferences, because novel therapies can
potentially give very different treatment options, which must be explained
for patients to make informed choices. |
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