新型口服抗凝血劑在亞洲缺血性腦中風病患之運用

Novel Oral Anticoagulants for Ischemic Stroke in Asia

腦中風與心房顫動息息相關，而中風所帶來的風險也隨著亞洲的老化人口增加。在新型口服抗凝血劑問市前，warfarin已被證實可有效下降心房顫動導致的中風風險。然而，亞洲族群的獨特性使得warfarin的服藥遵從性偏低。新型口服抗凝血劑在四大研究中已被證實，對於非瓣膜性心房顫動患者是個比warfarin更好的選擇。然而，亞洲族群在標準劑量及低劑量的選擇上需要更多研究作為治療佐證，不建議常規選擇低劑量使用來預防中風。

There is a close relationship between stroke and atrial fibrillation. The risk of stroke is increasing with the aging population in Asia. Warfarin had been proved to reduce the risk of cardioembolic stroke before novel oral anticoagulants (NOACs) launched. However, the drug compliance was poor because of the uniqueness of Asian ethnic groups. NOACs had been proved to be a better choice for patients of nonvalvular atrial fibrillation in the four studies included RE-LY trial, ROCKET AF trial, ENGAGE AF trial, and ARISTOTLE trial. However, we need more clinical trials to guide the treatment strategy between the choices of standard and low dosage in Asian population, and we did not recommend an unjustified underdosing.