...
  • 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >Prevention of Venous Thromboembolism, Recurrent Stroke, and Other Vascular Events After Acute Ischemic Stroke: The Role of Low-Molecular-Weight Heparin and Antiplatelet Therapy
【24h】

Prevention of Venous Thromboembolism, Recurrent Stroke, and Other Vascular Events After Acute Ischemic Stroke: The Role of Low-Molecular-Weight Heparin and Antiplatelet Therapy

机译：预防急性缺血性中风后静脉血栓栓塞，复发性中风和其他血管事件：低分子肝素和抗血小板治疗的作用

获取原文
获取原文并翻译 | 示例
           
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

Patients with stroke or transient ischemic attacks (TlAs) are at increased risk of vascular events, such as recurrent stroke or venous thrombbembblism (VTE), and thus the secondary prevention of such events is an important element of managing these patients. Current guidelines recommend that patients with acute stroke, restricted mobility, and no contraindications to anticoagulants receive thrombo-prophylactic therapy with low-dose unfractiohated heparin (UFH), low-molecular-weight heparin (LMWH), or heparinoids to prevent VTE. This, recommendation is based on clinical trial evidence that UFH is effective in reducing the incidence of deep vein thrombosis (DVT) after stroke. LMWHs have been shown to be at least as effective as UFH in preventing VTE, and offer advantages in terms of a more predictable anticoagulant effect, lower risk of bleeding, and ease of administration. However, adequately powered trials are needed to confirm their relative benefits and risks; the Prevention of VTE after Acute Ischemic Stroke with LMWH (PREVAIL) study with enoxaparin, currently in progress, should provide valuable information in this context. Antiplatelet therapy has been shown to be effective in preventing recurrent vascular events, as evidenced by the results of studies such as the Clopidogrel versus Aspirin in Patients at Risk of Ischaemic Events (CAPRIE) trial. In contrast, evidence for the efficacy of LMWH in this situation is contradictory. Given the potential benefits of LMWH in preventing VTE in stroke patients, a potential rationale exists for combination therapy with antiplatelet agents and LMWHs. Clinical trials with such combinations are warranted.
机译：中风或短暂性脑缺血发作（TlA）的患者发生血管事件（例如复发性中风或静脉血栓栓塞症（VTE））的风险增加，因此，二级预防此类事件是管理这些患者的重要因素。当前的指南建议患有急性中风，活动受限且无抗凝药禁忌症的患者应接受低剂量肝素（UFH），低分子量肝素（LMWH）或类肝素预防VTE的血栓预防性治疗。此建议基于临床试验证据，即UFH可有效减少中风后深静脉血栓形成（DVT）的发生。 LMWHs在预防VTE方面至少与UFH一样有效，并且在更可预测的抗凝作用，较低的出血风险和易于给药方面具有优势。但是，需要进行充分试验以确认其相对利益和风险;目前正在进行的使用依诺肝素的LMWH（PREVAIL）预防急性缺血性卒中后VTE的研究应在此方面提供有价值的信息。研究表明，抗血小板治疗可有效预防复发性血管事件，如氯吡格雷与阿司匹林在缺血性事件风险患者中的研究结果（CAPRIE）试验证明。相反，在这种情况下，LMWH疗效的证据是矛盾的。鉴于LMWH在预防中风患者VTE中的潜在益处，因此存在与抗血小板药和LMWH联合治疗的潜在理由。这种组合的临床试验是必要的。

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号