2017 consensus of the Asia Pacific Heart Rhythm Society on stroke prevention in atrial fibrillation.
2017 consensus of the Asia Pacific Heart Rhythm Society on stroke prevention in atrial fibrillation.
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DOI：
10.1016/j.joa.2017.05.004
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发表时间：
2017-08
影响因子：
2
通讯作者：
Siong Teo W
中科院分区：
文献类型：
--
作者：
Chiang CE;Okumura K;Zhang S;Chao TF;Siu CW;Wei Lim T;Saxena A;Takahashi Y;Siong Teo W
房颤（AF）是最常见的持续性心律失常，导致死亡率增加2倍，卒中增加5倍。亚洲人口正在迅速老龄化，到2050年，估计房颤患者将达到7200万人，其中290万人可能患有房颤相关的中风。因此，房颤卒中预防在亚洲是一个紧迫的问题。最近在房颤相关卒中的管理方面出现了许多创新进展，包括预测卒中和出血风险的新评分系统，非维生素K拮抗剂口服抗凝剂（NOACs）的开发，对其在亚洲人中的特殊益处的了解，以及新技术。亚太心律学会（APHRS）旨在更新现有信息，并任命实践指南小组委员会撰写关于房颤卒中预防的共识声明。实践指南小组委员会成员全面审查了房颤卒中预防的最新信息，强调了亚太地区noac的数据。并在2017年亚太心律学会关于房颤卒中预防的共识中对其进行了总结。该共识包括更新建议的细节，以及其背景和理由，重点关注亚太地区的数据。我们希望这一共识能够成为该地区心脏病学家、神经科医生、老年病学专家和全科医生的实用工具。我们充分认识到，在目前AF的知识中存在差距、未解决的问题和许多不确定的领域和争论，并且医生的决定仍然是AF管理中最重要的因素。
Atrial fibrillation (AF) is the most common sustained arrhythmia, causing a 2-fold increase in mortality and a 5-fold increase in stroke. The Asian population is rapidly aging, and in 2050, the estimated population with AF will reach 72 million, of whom 2.9 million may suffer from AF-associated stroke. Therefore, stroke prevention in AF is an urgent issue in Asia. Many innovative advances in the management of AF-associated stroke have emerged recently, including new scoring systems for predicting stroke and bleeding risks, the development of non-vitamin K antagonist oral anticoagulants (NOACs), knowledge of their special benefits in Asians, and new techniques. The Asia Pacific Heart Rhythm Society (APHRS) aimed to update the available information, and appointed the Practice Guideline sub-committee to write a consensus statement regarding stroke prevention in AF. The Practice Guidelines sub-committee members comprehensively reviewed updated information on stroke prevention in AF, emphasizing data on NOACs from the Asia Pacific region, and summarized them in this 2017 Consensus of the Asia Pacific Heart Rhythm Society on Stroke Prevention in AF. This consensus includes details of the updated recommendations, along with their background and rationale, focusing on data from the Asia Pacific region. We hope this consensus can be a practical tool for cardiologists, neurologists, geriatricians, and general practitioners in this region. We fully realize that there are gaps, unaddressed questions, and many areas of uncertainty and debate in the current knowledge of AF, and the physician׳s decision remains the most important factor in the management of AF.