Эмболический инсульт, фибрилляция предсердий и микрокровоизлияния. Какова роль антикоагулянтной терапии?


Г.-К. Диенер, М.Г. Селим, К.А. Молина, С.М. Гринберг

Department of Neurology, Stroke Center, University Hospital Essen, Essen, Germany; Hemorrhagic Stroke Research Unit, Massachusetts General Hospital, Harvard Medical School, Boston; Stroke Division, Beth Israel Deaconess Medical Center, Boston, MA; and Stroke Unit, Department of Neurology, Hospital Vall d’Hebron-Barcelona, Barcelona, Spain.

Литература


  1. Hart R.G., Pearce L.A., Aguilar M.I. Meta-analysis: antithrombotic therapy to prevent stroke in patients who have nonvalvular atrial fibrillation. Ann Intern Med. 2007;146:857–867.
  2. Vanassche T., Lauw M.N., Eikelboom J.W., Healey J.S., Hart R.G., Alings M., et al. Risk of ischaemic stroke according to pattern of atrial fibrillation: analysis of 6563 aspirin-treated patients in ACTIVE-A and AVERROES. Eur Heart J. 2015;36:281–287a. doi: 10.1093/eurheartj/ehu307.
  3. Charidimou A., Shakeshaft C., Werring D.J. Cerebral microbleeds ­on magnetic resonance imaging and anticoagulant-associated intracerebral hemorrhage risk. Front Neurol. 2012;3:133. doi: 10.3389/fneur.2012.00133.
  4. Horstmann S., Möhlenbruch M., Wegele C., Rizos T., Laible M., Rauch G., et al. Prevalence of atrial fibrillation and association of previous antithrombotic treatment in patients with cerebral microbleeds. Eur J Neurol. 2015;22:1355–1362. doi: 10.1111/ene.12608.
  5. Saito T., Kawamura Y., Sato N., Kano K., Takahashi K., Asanome A., et al. Non-vitamin k antagonist oral anticoagulants do not increase cerebral microbleeds. J Stroke Cerebrovasc Dis. 2015;24:1373–1377. doi:10.1016/j.jstrokecerebrovasdis.2015.02.018.
  6. Fisher M. MRI screening for chronic anticoagulation in atrial fibrillation. Front Neurol. 2013;4:137. doi: 10.3389/fneur.2013.00137.
  7. Easton J.D., Lopes R.D., Bahit M.C., Wojdyla D.M., Granger C.B., Wallentin L., et al; ARISTOTLE Committees and Investigators. Apixaban compared with warfarin in patients with atrial fibrillation and previous stroke or transient ischaemic attack: a subgroup analysis of the ARISTOTLE trial. Lancet Neurol. 2012;11:503–511. doi: 10.1016/S1474-4422(12)70092-3.
  8. Diener H.C., Connolly S.J., Ezekowitz M.D., Wallentin L., Reilly P.A., Yang S., et al; RE-LY Study Group. Dabigatran compared with warfarin in patients with atrial fibrillation and previous transient ischaemic attack or stroke: a subgroup analysis of the RE-LY trial. Lancet Neurol. 2010;9:1157–1163. doi: 10.1016/S1474-4422(10)70274-X.
  9. Hankey G.J., Patel M.R., Stevens S.R., Becker R.C., Breithardt G., Carolei A., et al; ROCKET AF Steering Committee Investigators. Rivaroxaban compared with warfarin in patients with atrial fibrillation and previous stroke or transient ischaemic attack: a subgroup analysis of ROCKET AF. Lancet Neurol. 2012;11:315–322. doi: 10.1016/S1474-4422(12)70042-X.
  10. Ntaios G., Papavasileiou V., Diener H.C., Makaritsis K., Michel P. Nonvitamin-K-antagonist oral anticoagulants in patients with atrial fibrillation and previous stroke or transient ischemic attack: a systematic review and meta-analysis of randomized controlled trials. Stroke. 2012;43:3298–3304. doi: 10.1161/STROKEAHA.112.673558.
  11. Rosand J., Eckman M.H., Knudsen K.A., Singer D.E., Greenberg S.M. The effect of warfarin and intensity of anticoagulation on outcome of intracerebral hemorrhage. Arch Intern Med. 2004;164:880–884. doi: 10.1001/archinte.164.8.880.
  12. Fang M.C., Go A.S., Chang Y., Hylek E.M., Henault L.E., Jensvold N.G., et al. Death and disability from warfarin-associated intracranial and extracranial hemorrhages. Am J Med. 2007;120:700–705. ­doi: 10.1016/j.amjmed.2006.07.034.
  13. Hart R.G., Pearce L.A., Aguilar M.I. Meta-analysis: antithrombotic therapy to prevent stroke in patients who have nonvalvular atrial fibrillation. Ann Intern Med. 2007;146:857–867.
  14. Eckman M.H., Rosand J., Knudsen K.A., Singer D.E., Greenberg S.M. Can patients be anticoagulated after intracerebral hemorrhage? ­A decision analysis. Stroke. 2003;34:1710–1716. doi: 10.1161/01.STR.0000078311.18928.16.
  15. Hemphill J.C. III, Greenberg S.M., Anderson C.S., Becker K., Bendok B.R., Cushman M., et al; American Heart Association Stroke Council; Council on Cardiovascular and Stroke Nursing; Council on Clinical Cardiology. Guidelines for the Management ­of Spontaneous Intracerebral Hemorrhage: A Guideline ­for Healthcare Professionals From the American Heart Association/American Stroke Association. Stroke. 2015;46:2032–2060. ­doi: 10.1161/STR.0000000000000069.
  16. Martinez-Ramirez S., Romero J.R., Shoamanesh A., McKee A.C., ­Van Etten E., Pontes-Neto O., et al. Diagnostic value of lobar microbleeds in individuals without intracerebral hemorrhage. Alzheimers Dement. 2015;11:1480–1488. doi: 10.1016/j.jalz.2015.04.009.
  17. Vernooij M.W., van der Lugt A., Ikram M.A., Wielopolski P.A., Niessen W.J., Hofman A., et al. Prevalence and risk factors ­of cerebral microbleeds: the Rotterdam Scan Study. Neurology. 2008;70:1208–1214. doi:10.1212/01.wnl.0000307750.41970.d9.
  18. van Etten E.S., Auriel E., Haley K.E., Ayres A.M., Vashkevich A., Schwab K.M., et al. Incidence of symptomatic hemorrhage ­in patients with lobar microbleeds. Stroke. 2014;45:2280–2285. doi: 10.1161/STROKEAHA.114.005151.
  19. Verbeek M.M., Kremer B.P., Rikkert M.O., Van Domburg P.H., Skehan M.E., Greenberg S.M. Cerebrospinal fluid amyloid beta(40) is decreased in cerebral amyloid angiopathy. Ann Neurol. 2009;66:245–249. doi: 10.1002/ana.21694.
  20. Soo Y.O., Yang S.R., Lam W.W., Wong A., Fan Y.H., Leung H.H., ­et al. Risk vs benefit of anti-thrombotic therapy in ischaemic stroke patients with cerebral microbleeds. J Neurol. 2008;255:1679–1686. doi: 10.1007/s00415-008-0967-7.
  21. Ruff C.T., Giugliano R.P., Braunwald E., Hoffman E.B., Deenadayalu N., Ezekowitz M.D., et al. Comparison of the efficacy and safety of new oral anticoagulants with warfarin in patients with atrial fibrillation: ­a metaanalysis of randomised trials. Lancet. 2014;383:955–962. doi: 10.1016/S0140-6736(13)62343-0.
  22. Smith C.M. Origin and uses of primum non nocere–above all, do no harm! J Clin Pharmacol. 2005;45:371–377. ­doi: 10.1177/0091270004273680.
  23. Connolly S.J., Eikelboom J., Joyner C., Diener H.C., Hart R., Golitsyn S., et al; AVERROES Steering Committee and Investigators. Apixaban ­in patients with atrial fibrillation. N Engl J Med. 2011;364:806–817. doi:10.1056/NEJMoa1007432.


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