심방세동 환자에서 Warfarin 단일요법과 Warfarin-Aspirin 병용요법 간의 출혈경향 발생과 뇌졸중 예방효과 고찰
Risk of Bleeding and Effect of Stroke Prevention Between Warfarin Single Therapy and Warfarin-Aspirin Combination Therapy in Patients with Atrial Fibrillation
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Atrial fibrillation (AF), the most common sustained arrhythmia, confers an independent risk factor for stoke. If the disease is not treated, stroke risk will increase more than five times, and about one in three people will experience a stroke during their life time. Therefore, AF needs active management, and anticoagulation therapy is effective in the prevention of stroke. Warfarin and aspirin, the medicines for the prevention and treatment of thromboembolism, are effective in the prevention of stroke in AF. Medication is determined by stroke risk, generally classified by CHADS2 score. Warfarin is recommended primarily for high-risk patients, and aspirin is recommended for low-risk patients and those unable to take warfarin. Despite the combined warfarin-aspirin therapy is not recommended in general, complementary effects are expected due to different mechanisms of the drug. However, some cases have been reported that the combination of these medications just administered to increase bleeding risks and did not represent a remarkable therapeutic effect. Therefore, this study is in 2011, Jan. 1 to Oct. 31 in outpatients with AF who underwent the anticoagulation therapy, and patients were classified according to medication uses. This study was analyzed cardiovascular diseases, medical treatments, and hematologic data. In addition, this study retrospectively analyze the status of anticoagulation therapy in patients with AF. The warfarin group and warfarin+aspirin group were 54 and 51 patients and average duration of drug administration were 4.7 and 3.6 months, respectively. Bleeding events occurred in 5 and 6 patients in warfarin group and warfarin+aspirn group, respectively. Retrospective analysis of the two drugs showed no significant differences between the bleeding risk and stroke prevention, additional research is needed for the clinical evaluation of the combination therapy of warfarin and aspirin.
Abstract
Atrial fibrillation (AF), the most common sustained arrhythmia, confers an independent risk factor for stoke. If the disease is not treated, stroke risk will increase more than five times, and about one in three people will experience a stroke during their life time. Therefore, AF needs active management, and anticoagulation therapy is effective in the prevention of stroke. Warfarin and aspirin, the medicines for the prevention and treatment of thromboembolism, are effective in the prevention of stroke in AF. Medication is determined by stroke risk, generally classified by CHADS2 score. Warfarin is recommended primarily for high-risk patients, and aspirin is recommended for low-risk patients and those unable to take warfarin. Despite the combined warfarin-aspirin therapy is not recommended in general, complementary effects are expected due to different mechanisms of the drug. However, some cases have been reported that the combination of these medications just administered to increase bleeding risks and did not represent a remarkable therapeutic effect. Therefore, this study is in 2011, Jan. 1 to Oct. 31 in outpatients with AF who underwent the anticoagulation therapy, and patients were classified according to medication uses. This study was analyzed cardiovascular diseases, medical treatments, and hematologic data. In addition, this study retrospectively analyze the status of anticoagulation therapy in patients with AF. The warfarin group and warfarin+aspirin group were 54 and 51 patients and average duration of drug administration were 4.7 and 3.6 months, respectively. Bleeding events occurred in 5 and 6 patients in warfarin group and warfarin+aspirn group, respectively. Retrospective analysis of the two drugs showed no significant differences between the bleeding risk and stroke prevention, additional research is needed for the clinical evaluation of the combination therapy of warfarin and aspirin.
참고문헌 (12)
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