非瓣膜性房颤并急性缺血性卒中抗凝治疗时机

Anticoagulation initiation after non⁃valvular atrial fibrillation with acute ischemic stroke

抗凝治疗是非瓣膜性房颤合并急性缺血性卒中的脑卒中二级预防重要策略,但其最佳启动时机尚无一致性意见。近年的循证医学证据发现急性缺血性卒中后早期启动抗凝治疗较延期抗凝治疗更具优势。本文拟对非瓣膜性房颤合并急性缺血性卒中患者抗凝治疗的启动时机进行综述,以期在平衡减少脑卒中复发与降低出血性转化风险的基础上,为此类患者选择更合理的抗凝治疗启动时机提供参考。

Anticoagulant treatment is an important strategy for secondary stroke prevention in non⁃valvular atrial fibrillation and acute ischemic stroke patients.However,the optimal timing for anticoagulation initiation after acute ischemic stroke has remained uncertain.In recent years,new clinical evidence has identified the benefit of early anticoagulation initiation rather than delayed anticoagulation initiation after acute ischemic stroke.This article reviews the literature on the topic of anticoagulation initiation in non⁃valvular atrial fibrillation with acute ischemic stroke patients.It helps physicians making decision to initiate anticoagulation at a more reasonable time point after balancing the risk of stroke recurrence and hemorrhagic transformation.