衰弱对于老年心房颤动患者抗凝决策的影响

Effect of frailty on anticoagulation in elderly patients with atrial fibrillation

摘要:

心房颤动(简称房颤)是老年患者最常见的心律失常,房颤患者的衰弱率随着年龄增长而增加,表现为躯体储备功能下降和并发症增加,影响抗凝治疗的安全性。老年房颤患者栓塞风险较高,除了进行栓塞评分外,还应进行衰弱评估,个体化地选择抗凝方案。衰弱的老年房颤患者不应拒绝抗凝治疗,使用新型口服抗凝药物会有更多获益。本文就衰弱对老年房颤患者的抗凝决策进行论述。

Abstract:

Atrial fibrillation is the most common arrhythmia in the elderly patients. The incidence of frailty in patients with atrial fibrillation increases with age as manifested by decreased physical functional reserve, increased complications, and effect on the safety of anticoagulation therapy. Considering the high risk of embolization in elderly patients with atrial fibrillation, it is necessary, in addition to assessment of embolism, to assess frailty and individualize anticoagulation regimen. Anticoagulation should not be refused for the elderly with frailty, and the gains might be better with new oral anticoagulants. This article reviews the anticoagulation strategies in elderly patients with atrial fibrillation.