栓塞、缺血和出血风险

María Asunción Esteve-Pastor , José Miguel Rivera-Caravaca , Vanessa Roldán , Francisco Marín
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引用次数: 0

摘要

心房颤动是普通人群中最常见的心律失常。它的存在使血栓栓塞事件的风险增加了5倍。虽然抗血栓治疗降低了这种风险,但相反,它增加了出血的潜在风险,颅内出血是最可怕的并发症。然而,并不是所有的病人都有同样的风险。因此,近年来出现了许多不同的血栓栓塞风险评分(如CHADS2、CHA2DS2-VASc和心房卒中风险评分)。CHA2DS2-VASc评分是临床实践指南推荐的用于优化房颤患者抗血栓治疗的评分。这些相同的临床指南建议对出血和血栓栓塞风险进行评估,并提出了各种风险评分来评估出血风险(例如HEMORR2HAGES, HAS-BLED,心房出血风险和眶-房颤评分)。然而,目前在欧洲的指导方针中没有明确推荐。至关重要的是,评估抗血栓治疗的净临床效益,以确保抗凝治疗的预期优势超过潜在出血可能造成的危害。补充信息:本文是由勃林格殷格翰公司赞助的题为“经皮冠状动脉介入治疗心房颤动患者:最新进展”的补充文章的一部分。
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Riesgo embólico, riesgo isquémico y riesgo hemorrágico

Atrial fibrillation is the most prevalent cardiac arrhythmia in the general population. Its presence increases the risk of thromboembolic events 5-fold. Although antithrombotic treatment reduces this risk, in contrast it increases the potential risk of bleeding, with intracranial hemorrhage being the most feared complication. However, not all patients have the same risk. Consequently, a number of different thromboembolic riskscores have been developed in recent years (e.g. the CHADS2, CHA2DS2-VASc and ATRIA stroke risk scores). The CHA2DS2-VASc score is the one recommended by clinical practice guidelines for optimizing antithrombotic therapy in patients with atrial fibrillation. These same clinical guidelines recommend that both bleeding and thromboembolic risk should be assessed and various risk scores have been proposed for assessing hemorrhagic risk (e.g. the HEMORR2HAGES, HAS-BLED, ATRIA bleeding risk and ORBIT-AF scores). Currently, however, none has been explicitly recommended in European guidelines. It is vital that the net clinical benefit of antithrombotic therapy is assessed to ensure that the expected advantages of anticoagulation treatment outweigh the harm that could be caused by potential hemorrhages.

Supplement information: this article is part of a supplement entitled “Treatment of patients with atrial fibrillation undergoing percutaneous coronary intervention: an update”, which is sponsored by Boehringer Ingelheim.

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来源期刊
Revista Espanola de Cardiologia Suplementos
Revista Espanola de Cardiologia Suplementos Medicine-Cardiology and Cardiovascular Medicine
CiteScore
1.20
自引率
0.00%
发文量
1
期刊介绍: Revista Española de Cardiología, is an international scientific journal dealing with cardiovascular medicine. Revista Española de Cardiología, the official publication of the Spanish Society of Cardiology, publishes research articles related to cardiovascular diseases. Articles are published in Spanish for the paper edition and in both Spanish and English in the electronic edition, which is available on the Internet. Regular sections include original articles reporting clinical or basic research, brief reports, review articles, editorials and letters to the Editor.
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