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JAMA:心房颤动筛查帮助降低中风风险

来源:生物谷 2015-11-17 09:42

图片来源:infoaboutsymptoms.com

2015年11月17日 讯 /生物谷BIOON/ --近日,来自悉尼大学的研究人员通过研究表明,对65岁及以上的个体进行无症状的心房颤动筛查并且利用抗凝药物进行治疗或许可以极大程度地降低个体因中风死亡和过早死亡的风险,相关研究刊登于国际杂志Journal of the American Medical Association上。

心房颤动(AF)是一种异常的心脏节律,其会给患者带来心脏血栓的风险,当血液凝块破碎就会流入大脑引发严重的中风。此前研究人员发现,相比年龄和性别相当的无心房颤动的个体而言,无症状的心房颤动个体中风和过早死亡的风险是前者的2倍。大量证据表明,利用口服抗凝药物华法林或新型的口服抗凝血药来治疗无症状的心房颤动或可完全逆转个体中风的风险,同时还可以部分逆转个体过早死亡的风险。

研究者Ben Freedman教授指出,对无症状的心房颤动患者的全面筛查可以帮助有效降低个体中风及相关残疾的风险,同时也可以挽救患者生命;但目前这种筛查程序被未在指导方针中推荐。心房颤动是一种常见的严重心脏心律失常表现,每3个中风患者中就有1名患者存在问题,而在27%的心房颤动相关的中风患者中,心脏心律的失常往往并不会先于无症状心房颤动而被检测出来;随机地检测心房颤动通常和心悸或心律升高并不直接相关,这就可以帮助解释为何中风发生非常意外,而且还是心房颤动的严重表现。

文章中,研究人员发现,心房颤动可以通过利用新型的手掌式设备吸附于iPhone,检测患者的心电图从而获取检测结果,基于iPhone的心电图设备可以在30秒内对心房颤动进行检测;利用如此简单的方法来检测心房颤动,就可以利用特殊疗法来有效改善患者较差的预后,研究者认为合理且有效的筛查手段对于检测异常心律的个体非常重要,对于改善其健康水平或许也将提供一定的帮助。(生物谷Bioon.com)

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Asymptomatic Atrial Fibrillation The Case for Screening to Prevent Stroke

S. Ben Freedman, MBBS, PhD1,2,3; Nicole Lowres, BPhty, PhD1,2,3

This Viewpoint proposes widespread screening for atrial fibrillation using accessible and inexpensive means as a public health intervention for preventing stroke. Atrial fibrillation is very common, such that by age 40 years, there is a 1 in 4 lifetime risk of developing atrial fibrillation.1 The prevalence of atrial fibrillation increases substantially with advancing age, from 0.5% at age 40 through 50 years to 5% through 15% at age 80 years. Atrial fibrillation significantly increases the risk of mortality, heart failure, and myocardial infarction, as well as the risk of stroke, which may be severe due to a cardioembolic origin. However, treatment of patients with atrial fibrillation with oral anticoagulation is effective in reducing stroke risk by approximately two-thirds and reducing mortality by almost one-third, with a relatively smaller increased risk of major bleeding, such that the net clinical benefit favors anticoagulation for almost all patients with atrial fibrillation.2 European and US guidelines therefore recommend anticoagulant therapy when stroke risk, as calculated by CHA2DS2-VASc score, is 2 or higher.1,2 Such pronounced treatment effects are rarely seen in therapies for other conditions for which screening is undertaken.

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