心房顫動的抗凝治療

Anticoagulant Therapy in Atrial Fibrillation

預防中風在心房顫動治療中至關重要。雖然warfarin（Coumadin）可有效降低心房顫動的中風風險達64％，但由於其併發症和局限性，大大降低醫師處方的意願和患者的順從性。因此，warfarin（Coumadin）的使用不足一直是一個全球性的問題。目前已有四種不同於warfarin（Coumadin）的新型口服抗凝劑問世，新型口服抗凝劑在預防缺血性腦中風方面具有與warfarin（Coumadin）同等的功效，並且大幅降低腦出血的風險。在新型口服抗凝劑的時代，醫師能夠更簡易、更安全地處方抗凝劑給需要抗凝治療的心房顫動病患。隨著我們對於新型口服抗凝劑的了解與使用經驗的增加，也為心房顫動患者帶來更好的預後。

Stroke prevention is crucial for the managements of atrial fibrillation (AF). Most thromboembolic events of AF are prominently deferred with oral anticoagulants (OACs). Although warfarin effectively reduces the risk of AF-associated stroke by 64% and all-cause mortality by 26% compared to control/placebo, the underuse of warfarin (Coumadin) remains a worldwide issue due to its complications and limitations, which bothered both physicians and patients. With the introduction of novel oral anticoagulants (NOACs), which are at least as effective as warfarin (Coumadin) for stroke prevention, and are much safer especially with regard to the risk of intra-cranial hemorrhage, more and more AF patients received OACs to prevent stroke. These advances in AF-associated stroke management would positively convert into better outcomes for AF patients, especially as our knowledge and experience with NOACs grow.