亚洲人群房颤后中现状及治疗进展课件.pptVIP

G02-536 w_script.ppt * * Reference Biessels GJ, Zwanenburg JJ, Visser F, et al. Hypertensive cerebral hemorrhage: imaging the leak with 7-T MRI. Neurology. 2010;75(6):572-3. * * Reference Lovelock CE, Cordonnier C, Naka H et al. Antithrombotic drug use, cerebral microbleeds, and intracerebral hemorrhage: a systematic review of published and unpublished studies. Stroke. 2010;41(6):1222-8. * * There are many targets for novel anticoagulants in the coagulation pathway: Tissue factor pathway inhibitor (TFPI) bound to Factor Xa inactivates the tissue factor (TF)–Factor VIIa complex, preventing initiation of coagulation Activated protein C (APC) degrades Factors Va and VIIIa, and thrombomodulin (soluble; sTM) converts thrombin (Factor IIa) from a procoagulant to a potent activator of protein C Fondaparinux and idraparinux indirectly inhibit Factor Xa, requiring antithrombin (AT) as a cofactor Direct (AT-independent) inhibitors of Factor Xa include rivaroxaban (BAY?59-7939), LY517717, YM150 and DU-176b (all orally available), and DX-9065a (intravenous) Oral, direct thrombin inhibitors include ximelagatran (now withdrawn) and dabigatran Weitz JI Bates SM. New anticoagulants. J Thromb Haemost 2005;3:1843–1853 AVERROES is a randomized, phase III, double-blind, double-dummy event-driven trial in which ~5,600 patients with non-valvular AF and at least one risk factor for future stroke who had been shown to be unsuitable for VKA therapy or were expected to be unsuitable for VKA therapy were randomized to receive either: Apixaban (5 mg twice daily or 2.5 mg twice daily for patients with at least 2 of the following criteria: age ≥80 years, body weight ≤60 kg, serum creatinine ≥1.5 mg/dl) Or ASA (81?324 mg od) The main objective of the study is to demonstrate superior efficacy of apixaban vs ASA for the prevention of all-cause stroke and systemic embolism The patient population and the study endpoints are detailed in the following slides Abbreviations AF, atrial fibri