Anticoagulation advance in atrial fibrillation

doi:10.3969/j.issn.1004-583X.2016.01.004

Abstract

Abstract: Atrial fibrillation (AF) is one of the most common tachyarrhythmias in clinical practice. AF increases the risk of stroke. Warfarin has been proven effective. However, the high risk of bleeding, narrow therapeutic window, long term INR monitoring for proper adjustment of medication are the major drawbacks of this medicine. The novel oral anticoagulants (NOACs) such as dabigatran, rivaroxaban, and apixaban are effective and safe alternative to warfarin for the prevention of stroke and systemic emboli in patients with AF. Percutaneous left atrial appendage occlusion may be an effective alternative treatment for prevention of thromboembolic events in AF patients.

Key words: atrial fibrillation, anticoagulant therapy, warfarin, percutaneous left atrial appendage occlusion

CLC Number:

R541.75

Xue Li, Cai Heng. Anticoagulation advance in atrial fibrillation[J]. Clinical Focus, 2016, 31(1): 14-18.

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URL: https://huicui.hebmu.edu.cn/EN/10.3969/j.issn.1004-583X.2016.01.004

https://huicui.hebmu.edu.cn/EN/Y2016/V31/I1/14

References

[1] 周自强,胡大一,陈捷,等. “中国心房颤动现状流行病学研究”结果解读[J]. 中华内科杂志,2010,49(3):198-199.
[2] Go AS,Hylek,Phillips KA, et al. Prevalence of diagnosed atrial fibrillation in adults: national implications for rhythm management and stroke prevention: the Anticoagulation and Risk Factors in Atrial Fibrillation (ATRIA) Study[J].JAMA,2001,285(18):2370-2375.
[3] Wolf PA, Abbott RD,Kannel WB.Atrial fibrillation as an independent risk factor for stroke: the Framingham study[J].Stroke,1991,22(8):983-988.
[4] Singer DE, Albers GW, Dalen JE,et al. Antithrombotic Therapy in Atrial Fibrillation American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th edition) [J]. CHEST,2008,133( 6) :546S-592S.
[5] Hart RG,Sherman DG, Easton JD, et al. Prevention of stroke in patients with nonvalvular atrial fibrillation[J]. Neurology 1998,51:674-681.
[6] SPAFⅢ Writing Committee for the Stroke Prevention in Atrial Fibrilla-tion Investigatiors.Patients with non-valvular atrial fibrillation at low risk of stroke during treatment with aspirin: Stroke Prevention in Atrial Fibrillation Ⅲ Study[J].JAMA,1998,279:1273-1277.
[7] January CT,Wann LS,Alpert JS,et al. 2014 AHA /ACC /HRS Guideline for the Management of Patients With Atrial Fibrillation: A Report of the American College of Cardiology / American Heart Association Task Force on Practice Guidelines and the Heart Rhythm Society[J]. J Am Coll Cardiol,2014,64(21):2305-2307.
[8] Atrial fibrillation investigators. Echocardiographic predictors of stroke in patients with atrial fibrillation a prospective study of 1066 patients from three clinical trails[J]. Arch Intern Med, 1998, 158(13):1316-1320.
[9] Research group for antiarrhythmic drug therapy. Risk factors for thromboembolism in patients with atrial fibrillation during treatment with aspirin:a multicenter,cooperative retroapective study[J]. J Cardiol, 2000, 35(5): 373-379.
[10] Gage BF,Waterman AD, Shannon W, et al. Validation of clinical classification schemes for predicing stroke[J].JAMA,2001,285:2864-2870.
[11] Stroke Risk in Atrial Fibrillation Working Group. Comparison of 12 risk stratification schemes to predict stroke in patients with nonvalvular atrial fibrillation[J]. Stroke,2008,39(6):1901-1910.
[12] Camm AJ, Kirchhof P, Lip GY, et al. Guidelines for the management of atrial fibrillation:The Task Force For the Management of Atrial Fibrillation of the European Society of Cardiology(ESC)[J].Eur Heart J,2010,31(19):2369-2429.
[13] Olesen JB,Torp-Pedersen C,Hansen ML,et al. The value of the CHA2DS2-VASc score for refining stroke risk stratification in patients with atrial fibrillation with a CHADS₂ score 0-1: a nationwide cohort study[J]. Thromb Haemost,2012,107(6):1172-1179.
[14] Camm AJ,Lip GY,De Caterina R,et al. 2012 focused update of the ESC guidelines for the management of atrial fibrillation: an update of the 2010 ESC guidelines for the management of atrial fibrillation: developed with the special contribution of the European Heart Rhythm Association[J]. Eur Heart J,2012,33(21):2719-2747.
[15] January CT,Wann LS,Alpert JS,et al. 2014 AHA /ACC /HRS Guideline for the Management of Patients With Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the Heart Rhythm Society[J]. J Am Coll Cardiol,2014,64(21):2305-2307.
[16] 王春娟,王春雪,王拥军,等.中国非瓣膜性心房颤动患者华法林使用不足的相关因素分析[J].中国新药杂志,2012,21(11):1203-1209.
[17] Piccini JP,Stevens SR,Chang Y,et al. Renal dysfunction as a predictor of stroke and systemic embolism in patients with nonvalvular atrial fibrillation: validation of the R( 2) CHADS( 2) index in the ROCKET AF (Rivaroxaban Oncedaily Oral direct factor Xa inhibition compared with vitamin K antagonism for prevention of stroke and Embolism Trial in Atrial Fibrillation) and ATRIA ( AnTicoagulation and Risk factors in Atrial Fibrillation) study cohorts[J]. Circulation,2013,127(2):224-232.
[18] Inoue YY, Alissa A, Khurram IM,et al.Quantitative Tissue-Tracking Cardiac Magnetic Resonance (CMR) of Left Atrial Deformation and the Risk of Stroke in Patients With Atrial Fibrillation[J].J Am Heart Assoc,2015,4(4):e001844.
[19] January CT,Wann LS,Alpert JS,et al.2014 AHA／ACC／HRS guideline for the management of patients with atrial fibrillation:a report of the American College of Cardiology／American Heart Association Task Force on Practice Guidelines and the Heart Rhythm Society[J].J Am Coll Cardiol,2014,64:el-e76.
[20] Roldan V, Marin F,Manzano-Fernandez S,et al.The HAS·BLEDSCOre has better prediction accuracy for major bleeding than CHADS2 or CHA2 DS2-VASc scores in anticoagulated patients with atrial fibrillation[J].J Am Coil Cardiol,2013,62(23):2199-2204.
[21] Sato H, Ishikawa K, Kitabatake A,et al. Low-dose aspirin for prevention of stroke in low-risk patients with atrial fibrillation: Japan Atrial Fibrillation Stroke Trial[J]. Stroke, 2006,37(2):447-451.
[22] Hart RG,Pearce LA,Aguilar MI. Meta-analysis: antithrombotic therapy to prevent stroke in patients who have nonvalvular atrial fibrillation[J]. Ann InternMed,2007,146(12): 857-867.
[23] van Walraven C,Hart RG,Connolly S,et al.Effect of age on stroke prevention therapy in patients with atrial fibrillation: the atrial fibrillation investigators[J]. Stroke,2009,40(4):1410-1416.
[24] Wieloch M,Sjalander A,Frykman V,et al.Anticoagulation control in Sweden: reports of time in therapeutic range,major bleeding,and thrombo-embolic complications from the national quality registry Auricul A[J].Eur Heart J,2011,32( 18) : 2282-2289.
[25] Friberg L,Rosenqvist M,Lip GY.Evaluation of risk stratification schemes for ischaemic stroke and bleeding in 1 82 678 patients with atrial fibrillation:the Swedish Atrial Fibrillation cohort study[J].Eur Heart J,2012,33:1500-1510.
[26] Wan Y,Heneghan C,Perera R,et al.Anticoagulation control andprediction of adverse events in patients with atrial fibrillation: a systematic review[J].Circ Cardiovasc Qual Outcomes,2008,1(2):84-91.
[27] Yu HC, Chan TY, Critchley JA, et al. Fatctors determining the maintenance dose of wafarin in Chinese patients[J]. QJM, 1996, 89(2):127-135.
[28] 娄莹,华潞,韩璐璐,等.中国汉族人群华法林稳定剂量预测模型的建立与验证[J].中华心血管病杂志,2014,42(5): 384-388.
[29] De Caterina R,Husted S,Wallentin L,et al.New oral anticoagulants in atrial fibrillation and acute coronary syndrome:ESC Working Group on Thrombosis·Task Force on Anticoagulants in Heart Disease position paper[J].J Am Coil Cardiol,2012,(59):1413-1425.
[30] Connolly SJ,Ezekowitz MD,Yusuf S,et al.Dabigatran versus warfarin in patients with atrial fibrillation[J].N Engl J Med,2009,361( 12) : 1139-1151.
[31] Stangier J,Rathgen K,Stahle H, et al. Pharmacokinetics and pharmacodynamics of the direct oral thrombin inhibitor dabigatran in healthy elderly subjects[J].Clin Pharmacokinet, 2008(47):285-295.
[32] Glund S, Stangier J, Schmohl M, et al,Safety, tolerability, and efficacy of idarucizumab for the reversal of the anticoagulant effect of dabigatran in healthy male volunteers,Lancet,2015,386(9994):680-690.
[33] Patel MR, Mahaffey KW, Garg J, et al. Rivaroxaban versus warfarin in nonvalvular atrial fibrillation[J]. N Engl J Med, 2011, 365(10):883-891.
[34] Granger CB,Alexander JH,Mc Murray JJ,et al.Apixaban versus warfarin in patients with atrial fibrillation[J].N Engl J Med,2011,365(11):981-992.
[35] Al-Saady NM, Obel OA, Camm AJ. Left atrial appendage: structure, function, and role in thromboembolism[J]. Heart,1999,82(5):547-554.
[36] Block PC,Burstein S,Casale PN,et al. Percutaneous left atrial appendage occlusion for patients in atrial fibrillation suboptimal for warfarin therapy [J].JACC Cardiovasc Interv,2009,2(7):594-600.
[37] Reddy VY,Doshi SK,Sievert H,et al.Percutaneous left atrial appendage closure for stroke prophylaxis in patients with atrial fibrillation: 2.3-year follow-up of the PROTECTAF ( Watchman Left Atrial Appendage System for Embolic Protection in Patients with Atrial Fibrillation) trial[J].Circulation,2013,127(6):720-729.
[38] Holmes DR,Kar S,Price MJ,et al. Prospective randomized evaluation of the Watchman left atrial appendage closure device in patients with atrial fibrillation versus long-term warfarin therapy[J]. J Am Coll Cardiol,2014,64(1):1-12.
[39] Reddy VY, Mobius-Winkler S, Miller MA, et al. Left atrial appendage closure with the Watchman device in patients with a contraindication for oral anticoagulation:the ASAP study (ASA Plavix Feasibility Study With Watchman Left Atrial Appendage Closure Technology)[J].J Am Coll Cardiol,2013,61(25):2551-2556.