Application and challenge of novel oral anticoagulants in patients with nonvalvular atrial fibrillation

doi:10.12114/j.issn.1007-9572.2020.00.364

Abstract

Abstract: 　Risk assessment and prevention of stroke is an important part of comprehensive management of atrial fibrillation，the most common cardiac arrhythmia.Anticoagulation therapy is one intervention that can effectively reduce the incidence of atrial fibrillation-related stroke.Novel oral anticoagulants（NOACs）take effect by specifically blocking the key link in the development of clotting cascade，namely，the action of thrombin（coagulation factor Ⅱa） or coagulation factor Ⅹa，to inhibit the final stage of the coagulation pathway.NOACs，with the advantages of using a fixed dose，rapid oral absorption，small food-drug interactions，and using without monitoring routine coagulation indices，have become a hot research theme recently.This paper introduces the advances in clinical research and application of NOACs in atrial fibrillation，it is found that NOACs has the advantages of good efficacy and high safety，so as to guide clinical treatment.

Key words: Atrial fibrillation, Novel oral anticoagulants, Anticoagulant therapy, Review

摘要： 心房颤动是临床上最常见的心律失常，心房颤动所致的脑卒中风险的评估及预防是患者综合管理的重要内容之一，抗凝治疗可以有效降低脑卒中发生率。新型口服抗凝药物（NOACs）可特异性阻断凝血瀑布中关键性环节，即凝血酶（凝血因子Ⅱa）或凝血因子Ⅹa，进而抑制凝血通路的终末阶段，从而发挥抗凝作用。NOACs具有使用剂量固定、口服吸收快、与药物或食物相互作用较小，以及无须进行常规凝血指标监测等优势，近年来已成为研究的热点。本文介绍了NOACs在心房颤动方面的临床研究及应用进展，发现NOACs具有疗效好，安全性高等优点，以指导临床治疗。

关键词: 心房颤动, 新型口服抗凝药物, 抗凝治疗, 综述

LIU Yue,REN Yirong,ZHU Huolan, et al. Application and challenge of novel oral anticoagulants in patients with nonvalvular atrial fibrillation[J]. Chinese General Practice, 2020, 23(23): 2872-2876. DOI: 10.12114/j.issn.1007-9572.2020.00.364.
刘岳,任怡荣,朱火兰等. 新型口服抗凝药物在非瓣膜性心房颤动患者中的应用及挑战[J]. 中国全科医学, 2020, 23(23): 2872-2876. DOI: 10.12114/j.issn.1007-9572.2020.00.364.

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