ESC房颤指南卒中防治教学教案.pptVIP

2016年ESC/EACTS房颤管理指南——房颤患者的卒中预防治疗;;中国房颤患者数逾500万，且日趋增加;房颤是卒中发生的独立危险因素;房颤患者的卒中风险较非房颤患者升高5倍;房颤血栓形成机制复杂;血栓形成与抗栓治疗;;01;;出血的临床风险评分;卒中和出血风险预测的推荐;;Kirchhof P, et al. Eur Heart J. 2016 Aug 27. pii: ehw210. [Epub ahead of print];新型口服抗凝药;Kirchhof P, et al. Eur Heart J. 2016 Aug 27. pii: ehw210. [Epub ahead of print];华法林需要剂量调整和监测INR才能实现AF患者获益;; Kirchhof P, et al. Eur Heart J. 2016 Aug 27. pii: ehw210. [Epub ahead of print];Kirchhof P, et al. Eur Heart J. 2016 Aug 27. pii: ehw210. [Epub ahead of print];;;;Kirchhof P, et al. Eur Heart J. 2016 Aug 27. pii: ehw210. [Epub ahead of print];;;;;;;;Kirchhof P, et al. Eur Heart J. 2016 Aug 27. pii: ehw210. [Epub ahead of print];Kirchhof P, et al. Eur Heart J. 2016 Aug 27. pii: ehw210. [Epub ahead of print];目前，AF患者在DAPT基础上使用NOACs数据有限;有利于达比加群;有利于达比加群 ;Kirchhof P, et al. Eur Heart J. 2016 Aug 27. pii: ehw210. [Epub ahead of print];;;Kirchhof P, et al. Eur Heart J. 2016 Aug 27. pii: ehw210. [Epub ahead of print];Kirchhof P, et al. Eur Heart J. 2016 Aug 27. pii: ehw210. [Epub ahead of print];非头对头研究;无临床结论; adapted from references 1–5 CrCl ：肌酐清除率 CrCl calculated with Cockcroft-Gault formula in all studies 1. Hijazi et al. Circulation 2014; 2. Pradaxa?: EU SPC, 2015; 3. Hohnloser et al. Eur Heart J 2012; 4. Fox et al. Eur Heart J 2011; 5. Lixiana: EU SPC, 2015;;*Option to reduce dabigatran dose to 110 mg BID if high bleeding risk; reduce apixaban dose to 2.5 mg BID when at least two of the following occur: serum Cr ≥1.5 mg/dL, age ≥80 years or body weight ≤60 kg; ?In the USA, edoxaban is contraindicated in patients with CrCl 95 mL/min; ?CrCl 15–50 mL/min; §not recommended if CrCl15 mL/min 1. Pradaxa?: EU SPC, 2015; 2. Eliquis: EU SPC, 2015; 3. Xarelto: EU SPC, 2015; 4. Lixiana: EU SPC, 2015;附：内生肌酐清除率;总结;