English Polski
Tom 16, Nr 2 (2021)
Artykuł przeglądowy
Opublikowany online: 2021-04-30

dostęp otwarty

Wyświetlenia strony 392
Wyświetlenia/pobrania artykułu 688
Pobierz cytowanie

Eksport do Mediów Społecznościowych

Eksport do Mediów Społecznościowych

Dlaczego nie wszyscy chorzy z grupy wysokiego ryzyka zakrzepowo-zatorowego z migotaniem przedsionków są leczeni przeciwkrzepliwie?

Bernadetta Bielecka1, Iwona Gorczyca12, Beata Wożakowska-Kapłon12
Folia Cardiologica 2021;16(2):119-125.

Streszczenie

Powszechnie stosowaną skalą w ocenie ryzyka zakrzepowo-zatorowego u pacjentów z migotaniem przedsionków jest skala CHA2DS2-VASc. Doustne leki przeciwkrzepliwe zaleca się w zapobieganiu udarom mózgu u chorych z AF z wynikiem 2 lub więcej punktów w skali CHA2DS2-VASc u mężczyzn oraz 3 lub więcej punktów u kobiet. Znane są czynniki, których w niej nie uwzględniono, a znacząco zwiększają ryzyko zakrzepowo-zatorowe. Nie wszyscy chorzy z migotaniem przedsionków z grupy wysokiego ryzyka zakrzepowo-zatorowego są leczeni przeciwkrzepliwie. Wynika to przede wszystkim z przeciwwskazań do stosowania leków z tej grupy.

Artykuł dostępny w formacie PDF

Pokaż PDF Pobierz plik PDF

Referencje

  1. Camm AJ, Kirchhof P, Lip GYH, et al. Wytyczne dotyczące postępowania u chorych z migotaniem przedsionków. Kardiol Pol. 2010; 68(Suppl VII): 487–566.
  2. Hindricks G, Potpara T, Dagres N, et al. ESC Scientific Document Group . 2020 ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS). Eur Heart J. 2021; 42(5): 373–498.
  3. Lip GYH, Laroche C, Popescu MI, et al. Improved outcomes with European Society of Cardiology guideline-adherent antithrombotic treatment in high-risk patients with atrial fibrillation: a report from the EORP-AF General Pilot Registry. Europace. 2015; 17(12): 1777–1786.
  4. Hijazi Z, Lindbäck J, Alexander JH, et al. ARISTOTLE and STABILITY Investigators. The ABC (age, biomarkers, clinical history) stroke risk score: a biomarker-based risk score for predicting stroke in atrial fibrillation. Eur Heart J. 2016; 37(20): 1582–1590.
  5. Piccini JP, Stevens SR, Chang Y, et al. ROCKET AF Steering Committee and Investigators. Renal dysfunction as a predictor of stroke and systemic embolism in patients with nonvalvular atrial fibrillation: validation of the R(2)CHADS(2) index in the ROCKET AF (Rivaroxaban Once-daily, oral, direct factor Xa inhibition Compared with vitamin K antagonism for prevention of stroke and Embolism Trial in Atrial Fibrillation) and ATRIA (AnTicoagulation and Risk factors In Atrial fibrillation) study cohorts. Circulation. 2013; 127(2): 224–232.
  6. Cho S, Kim J, Kim JB, et al. The difference of burden of ectopic beats in different types of atrial fibrillation and the effect of atrial fibrillation type on stroke risk in a prospective cohort of patients with atrial fibrillation (CODE-AF registry). Sci Rep. 2020; 10(1): 6319.
  7. Overvad TF, Rasmussen LH, Skjøth F, et al. Body mass index and adverse events in patients with incident atrial fibrillation. Am J Med. 2013; 126(7): 640.e9–640.17.
  8. Hijazi Z, Oldgren J, Siegbahn A, et al. Application of biomarkers for risk stratification in patients with atrial fibrillation. Clin Chem. 2017; 63(1): 152–164.
  9. Lip GYH, Lane D, Van Walraven C, et al. Additive role of plasma von Willebrand factor levels to clinical factors for risk stratification of patients with atrial fibrillation. Stroke. 2006; 37(9): 2294–2300.
  10. Echocardiographic predictors of stroke in patients with atrial fibrillation. Arch Intern Med. 1998; 158(12): 1316–1320.
  11. Esteve-Pastor MA, Roldán V, Rivera-Caravaca JM, et al. The use of biomarkers in clinical management guidelines: a critical appraisal. Thromb Haemost. 2019; 119(12): 1901–1919.
  12. Sepehri Shamloo A, Bollmann A, Dagres N, et al. Natriuretic peptides: biomarkers for atrial fibrillation management. Clin Res Cardiol. 2020; 109(8): 957–966.
  13. Ioannou A, Papageorgiou N, Falconer D, et al. Biomarkers associated with stroke risk in atrial fibrillation. Curr Med Chem. 2019; 26(5): 803–823.
  14. Camm AJ, Kirchhof P, Lip GYH, et al. European Heart Rhythm Association, European Association for Cardio-Thoracic Surgery. Guidelines for the management of atrial fibrillation: the Task Force for the Management of Atrial Fibrillation of the European Society of Cardiology (ESC). Eur Heart J. 2010; 31(19): 2369–2429.
  15. Lip GYH. What is the most effective and safest delivery of thromboprophylaxis in atrial fibrillation? J R Coll Physicians Edinb. 2012; 42(Suppl 18): 35–44.
  16. Lip GYH. The role of aspirin for stroke prevention in atrial fibrillation. Nat Rev Cardiol. 2011; 8(10): 602–606.
  17. Olesen JB, Torp-Pedersen C, Hansen ML, et al. The value of the CHA2DS2-VASc score for refining stroke risk stratification in patients with atrial fibrillation with a CHADS2 score 0-1: a nationwide cohort study. Thromb Haemost. 2012; 107(6): 1172–1179.
  18. Lip GYH, Nieuwlaat R, Pisters R, et al. Refining clinical risk stratification for predicting stroke and thromboembolism in atrial fibrillation using a novel risk factor-based approach: the euro heart survey on atrial fibrillation. Chest. 2010; 137(2): 263–272.
  19. Hart RG, Pearce LA, Aguilar MI. Meta-analysis: antithrombotic therapy to prevent stroke in patients who have nonvalvular atrial fibrillation. Ann Intern Med. 2007; 146(12): 857–867.
  20. Steinberg BA, Gao H, Shrader P, et al. GARFIELD-AF, ORBIT-AF Investigators. International trends in clinical characteristics and oral anticoagulation treatment for patients with atrial fibrillation: Results from the GARFIELD-AF, ORBIT-AF I, and ORBIT-AF II registries. Am Heart J. 2017; 194: 132–140.
  21. Ding M, Fratiglioni L, Johnell K, et al. Atrial fibrillation and use of antithrombotic medications in older people: A population-based study. Int J Cardiol. 2017; 249: 173–178.
  22. Cools F, Wollaert B, Vervoort G, et al. GARFIELD-AF Investigators. Treatment patterns in anticoagulant therapy in patients with newly diagnosed atrial fibrillation in Belgium: results from the GARFIELD-AF registry. Acta Cardiol. 2019; 74(4): 309–318.
  23. Boriani G, Proietti M, Laroche C, et al. EORP-AF Long-Term General Registry Investigators, Steering Committee (National Coordinators). Contemporary stroke prevention strategies in 11 096 European patients with atrial fibrillation: a report from the EURObservational Research Programme on Atrial Fibrillation (EORP-AF) Long-Term General Registry. Europace. 2018; 20(5): 747–757.
  24. Kirchhof P, Ammentorp B, Darius H, et al. Management of atrial fibrillation in seven European countries after the publication of the 2010 ESC Guidelines on atrial fibrillation: primary results of the PREvention oF thromboemolic events--European Registry in Atrial Fibrillation (PREFER in AF). Europace. 2014; 16(1): 6–14.
  25. Cowan C, Healicon R, Robson I, et al. The use of anticoagulants in the management of atrial fibrillation among general practices in England. Heart. 2013; 99(16): 1166–1172.
  26. Holt TA, Hunter TD, Gunnarsson C, et al. Risk of stroke and oral anticoagulant use in atrial fibrillation: a cross-sectional survey. Br J Gen Pract. 2012; 62(603): e710–e717.
  27. Huisman MV, Rothman KJ, Paquette M, et al. GLORIA-AF Investigators. The changing landscape for stroke prevention in AF: fndings from the GLORIA-AF Registry Phase 2. J Am Coll Cardiol. 2017; 69(7): 777–785.
  28. Kirchhof P, Schmalowsky J, Pittrow D, et al. ATRIUM Study Group, ATRIUM investigators. Management of atrial fibrillation by primary care physicians in Germany: baseline results of the ATRIUM registry. Clin Res Cardiol. 2011; 100(10): 897–905.
  29. Chae SH, Froehlich J, Morady F, et al. Prevalence and predictors of warfarin use in patients with atrial fibrillation at low or intermediate risk and relation to thromboembolic events. Clin Cardiol. 2011; 34(10): 640–644.
  30. Krittayaphong R, Winijkul A, Methavigul K, et al. COOL-AF Investigators. Risk profiles and pattern of antithrombotic use in patients with non-valvular atrial fibrillation in Thailand: a multicenter study. BMC Cardiovasc Disord. 2018; 18(1): 174.
  31. Dalgaard F, Pieper K, Verheugt F, et al. GARFIELD-AF model for prediction of stroke and major bleeding in atrial fibrillation: a Danish nationwide validation study. BMJ Open. 2019; 9(11): e033283.
  32. Raji MA, Lowery M, Lin YL, et al. National utilization patterns of warfarin use in older patients with atrial fibrillation: a population-based study of Medicare Part D beneficiaries. Ann Pharmacother. 2013; 47(1): 35–42.
  33. O'Brien EC, Holmes DN, Ansell JE, et al. Physician practices regarding contraindications to oral anticoagulation in atrial fibrillation: findings from the Outcomes Registry for Better Informed Treatment of Atrial Fibrillation (ORBIT-AF) registry. Am Heart J. 2014; 167(4): 601–609.e1.
  34. Steinberg BA, Ballew NG, Greiner MA, et al. Ischemic and bleeding outcomes in patients with atrial fibrillation and contraindications to oral anticoagulation. JACC Clin Electrophysiol. 2019; 5(12): 1384–1392.
  35. Polo García J, Vargas Ortega D, Formiga F, et al. Profiling of patients with non-valvular atrial fibrillation and moderate-to-high risk of stroke not receiving oral anticoagulation in Spain. Semergen. 2019; 45(6): 396–405.
  36. Redfors B, Gray WA, Lee RJ, et al. Patients with atrial fbrillation who are not on anticoagulant treatment due to increased bleeding risk are common and have a high risk of stroke. JACC Clin Electrophysiol. 2017; 3(12): 1369–1376.
  37. Zaman JAB, Bhandari AK. Oral anticoagulants in patients with atrial fibrillation and end-stage renal disease. J Cardiovasc Pharmacol Ther. 2019; 24(6): 499–508.
  38. Arnson Y, Hoshen M, Berliner-Sendrey A, et al. Risk of stroke, bleeding, and death in patients with nonvalvular atrial fibrillation and chronic kidney disease. Cardiology. 2020; 145(3): 178–186.
  39. Kuo L, Chao TF, Liu CJ, et al. Liver crrhosis in patients with atrial fibrillation: would oral anticoagulation have a net clinical benefit for stroke prevention? J Am Heart Assoc. 2017; 6(6).
  40. Lutsey PL, Norby FL, Zakai NA, et al. Comparative effectiveness of direct oral anticoagulants and warfarin in patients with cancer and atrial fibrillation. Blood Adv. 2018; 2(3): 200–209.
  41. Carrier M, Abou-Nassar K, Mallick R, et al. AVERT Investigators. Apixaban to prevent venous thromboembolism in patients with cancer. N Engl J Med. 2019; 380(8): 711–719.
  42. Li A, Garcia DA, Lyman GH, et al. Direct oral anticoagulant (DOAC) versus low-molecular-weight heparin (LMWH) for treatment of cancer associated thrombosis (CAT): A systematic review and meta-analysis. Thromb Res. 2019; 173: 158–163.