Article, see p 1117

Recent trials of patients with atrial fibrillation (AF) have convincingly shown that anticoagulation with non–vitamin K antagonists or so-called novel oral anticoagulants (NOACs) are at least as effective as oral vitamin K antagonism by warfarin in reducing the risk of cardioembolic stroke and systemic embolism, but with a lower risk of serious bleeding events, in particular, intracranial hemorrhage.¹

Trial results have been supported by large registry studies in broad populations. AF frequently occurs in patients with underlying heart disease entities. In fact, up to one-third of all patients with AF have an underlying stable coronary artery disease, undergo coronary stenting, or will develop an acute coronary syndrome necessitating treatment with single- or 2-antiplatelet agents. The intersection between the 2 disease entities, AF and coronary artery disease, has gained a lot of attention and clinical and scientific interest recently. In patients with a recent acute coronary syndrome or stent procedure with or without AF, dual-antiplatelet therapy has been advocated to protect patients from stent thrombosis and recurrent ischemic events. However, adding anticoagulation for stroke prevention on …

文章，请参见第1117页

最近对房颤患者进行的试验令人信服地表明，使用非维生素K拮抗剂或所谓的新型口服抗凝剂（NOACs）进行的抗凝作用与华法林对口服维生素K的拮抗作用至少在降低心源性栓塞性中风风险方面有效和全身性栓塞，但发生严重出血事件（尤其是颅内出血）的风险较低。^1个

在广泛的人群中进行的大型注册研究为试验结果提供了支持。患有基础心脏病的患者经常发生房颤。实际上，所有房颤患者中有多达三分之一患有潜在的稳定冠状动脉疾病，接受冠状动脉支架置入术或将发展为急性冠状动脉综合症，因此需要使用单抗或2种抗血小板药物进行治疗。AF和冠状动脉疾病这两种疾病之间的交叉点最近引起了广泛的关注，并在临床和科学上引起了兴趣。在近期有或没有AF的急性冠脉综合征或支架手术患者中，已提倡双重抗血小板治疗以保护患者免受支架血栓形成和复发性缺血事件的影响。但是，在…上添加抗凝剂预防中风。