心血管疾病的溶栓抗栓治疗.ppt

In patients with AF, including those with paroxysmal AF, who have had a prior ischemic stroke, transient ischemic attack, or systemic embolism, we recommend long-term anticoagulation with an oral VKA, such as warfarin, targeted at an INR of 2.5 (range, 2.0 to 3.0) because of the high risk of future ischemic stroke faced by this set of patients (Grade 1A). 1.1.2. In patients with AF, including those with paroxysmal AF, who have two or more of the following risk factors for future ischemic stroke, we recommend long-term anticoagulation with an oral VKA, such as warfarin, targeted at an INR of 2.5 (range, 2.0 to 3.0) because of the increased risk of future ischemic stroke faced by this set of patients (Grade 1A). Two or more of the following risk factors apply: (1) age> 75 years, (2) history of hypertension, (3) diabetes mellitus, and (4) moderately or severely impaired left ventricular systolic function and/or heart failure. Remark: Recommendations 1.1.1 and 1.1.2 correspond to a recommendation of oral VKA therapy for individuals with a score 2 using the CHADS2 classification. For these and all other recommendations of long-term therapy in this chapter, “long-term” means lifelong unless a contraindication emerges. 1.1.3. In patients with AF, including those with paroxysmal AF, with only one of the risk factors listed below, we recommend long-term antithrombotic therapy (Grade 1A), either as anticoagulation with an oral VKA, such as warfarin, targeted at an INR of 2.5 (range, 2.0 to 3.0) [Grade 1A], or as aspirin, at a dose of 75 to 325 mg/d (Grade 1B). For these patients at intermediate risk of ischemic stroke, we suggest a VKA rather than aspirin (Grade 2A). This set of patients with AF is defined by having one of the following risk factors: (1) age > 75 years, (2) history of hypertension, (3) diabetes mellitus, and (4) moderately or severely impaired left ventricular systolic function and/or heart failure. 1.1.4. In patients with AF, including those with paroxysmal