Prevention of Cerebral Thromboembolism by Low-Dose Anticoagulant Therapy in Atrial Fibrillation with Mitral Regurgitation
Prevention of Cerebral Thromboembolism by Low-Dose Anticoagulant Therapy in Atrial Fibrillation with Mitral Regurgitation
复制标题
小剂量抗凝治疗心房颤动二尖瓣反流预防脑血栓栓塞
DOI：
10.1097/00005344-200104000-00009
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发表时间：
2001
影响因子：
3
通讯作者：
H. Matsuo
中科院分区：
文献类型：
--
作者：
Y. Wada;K. Mizushige;K. Ohmori;Y. Iwado;M. Kohno;H. Matsuo
关于二尖瓣反流（MR）对房颤患者血栓栓塞风险的影响存在争议。我们的目的是回顾性研究房颤患者因 MR 导致的卒中风险降低情况，并评估低强度抗凝治疗的有效性。对 313 名房颤患者进行了经胸超声心动图检查并进行了 MR 分级。对无或轻度 MR 组 (n = 209) 和中度或重度 MR (n = 104) 组之间的年龄、性别、治疗、糖尿病史、高血压、高脂血症和二尖瓣狭窄以及既往卒中情况进行比较。两组之间的临床特征、治疗或病史没有观察到显着差异。无 MR 组（48 名患者 [23%]）的血栓栓塞发生率显着高于有 MR 组（14 名患者 [13%]，p < 0.05）。在 MR 组中，与接受低剂量华法林治疗的患者（国际标准化比率为 1.6-1.8）（53 名患者中的 3 名，p < 0.05）相比，未接受华法林治疗的患者（51 名患者中的 11 名）经常观察到既往卒中。因此，低剂量华法林治疗显着预防了血栓栓塞事件。
Controversy exists regarding the influence of mitral regurgitation (MR) on thromboembolic risk in patients with atrial fibrillation. We aimed to investigate retrospectively a reduction of risk for stroke due to MR in atrial fibrillation and to evaluate the effectiveness of low-intensity anticoagulation therapy. In 313 patients with atrial fibrillation, transthoracic echocardiography was performed and MR was graded. Between the groups with no or mild MR (n = 209) and with moderate or severe MR (n = 104), age, sex, treatment, history of diabetes, hypertension, hyperlipemia and mitral stenosis, and previous stroke were compared. No significant differences in clinical characteristics, treatment, or history were observed between the two groups. The incidence of thromboembolism was significantly higher in the group with no MR (48 patients [23%]) than in the group with MR (14 patients [13%], p < 0.05). In the MR group, previous stroke was frequently observed in patients without warfarin treatment (11 of 51 patients) compared with patients with low-dose warfarin treatment (international normalized ratio of 1.6–1.8) (3 of 53 patients, p < 0.05). Consequently, the thromboembolic event was markedly prevented by low-dose warfarin treatment.
DOI：
10.1056/nejm199011293232201
发表时间：
1990-11
期刊：
The New England journal of medicine
影响因子：
--
作者：
D. Singer;R. Hughes;D. Gress;Mary A. Sheehan;L. Oertel;S. W. Maraventano;D. Blewett;B. Rosner;J. Kistler
通讯作者：
D. Singer;R. Hughes;D. Gress;Mary A. Sheehan;L. Oertel;S. W. Maraventano;D. Blewett;B. Rosner;J. Kistler