心房颤动抗栓治疗进展.pptVIP

**法林明显降低联合终点事件发生率（8.64%vs13.0%，P0.05），相对危险下降36%。********************ACTIVEisaphaseIII,multicenter,multinational,parallelrandomizedcontrolledevaluationofclopidogrelplusASA,withfactorialevaluationofirbesartan,forthepreventionofvasculareventsinpatientswithatrialfibrillation.Patientswillbeenrolledover2yearsandfollowedtocommonterminationdate(expectedtobeabout4yearsafterenrollmentofthefirstpatient).About14,000patientswillbeincludedintheACTIVEWorACTIVEAtrials.Duetothepartialfactorialdesign,patientswillonlyberandomizedinACTIVEIoncefirstrandomizedintoeitherACTIVEAorACTIVEW.ThreeseparatebutrelatedtrialsareincludedintheACTIVEstudy.TheseareknownasACTIVEW,ACTIVEA,andACTIVEI.ACTIVEW(n=6,500):Amulticenter,prospective,randomized,non-inferioritytrialofclopidogrelplusASAversusstandardcareoralanticoagulation(opentrialwithblindedoutcomeevaluation).ACTIVEA(n=7,500):Amulticenter,randomized,double-blind,placebo-controlledsuperioritytrialofclopidogrelplusASAversusASAalone.ACTIVEI(n=atleast10,000):Amulticenter,partialfactorial,randomized,double-blind,placebo-controlledsuperioritytrialofirbesartan.围手术期抗凝高危肝素15000Ubid低分子肝素100U/kg术前24小时停用静脉滴注（1300U/h）至术前5小时停用术前术后*术后12小时同时给予肝素与华法林持续4－5天直至INR达标*术后出血高危，肝素和低分子肝素推迟24小时或更长的时间。对牙科操作，可以用氨甲环酸、氨基乙酸漱口，不需要停用抗凝药物。中危术前4－5天停用华法林使INR1.3－1.5低危维持剂量华法林低剂量肝素（5000U）/低分子肝素皮下肝素5000U低分子肝素3000U皮下注射每日两次第23页，讲稿共39页，2023年5月2日，星期三妊娠患者的抗栓治疗除血栓低危患者，妊娠期间根据患者的危险分层采取抗栓治疗，抗凝或阿司匹林IIIIIaIIaIIaIIbIIbIIbIIIIIIIIIIIIIIaIIaIIaIIbIIbIIbIIIIIIIIIIIIIIaIIaIIaIIbIIbIIbIIIIIIIIIIIaIIaIIaIIbIIbIIbIIIIIIIIIC妊娠前3个月妊娠中期分娩前1个月UFHIV