脑中风的继发性预防

来源: Tianyazi 2012-08-25 20:00:04 [] [博客] [旧帖] [给我悄悄话] 本文已被阅读: 次 (8393 bytes)
本文内容已被 [ Tianyazi ] 在 2012-08-27 08:17:45 编辑过。如有问题,请报告版主或论坛管理删除.

Clinical trial results of Antiplatelet medications:

1 ASA Vs placebo:  reduces relative stroke risk by 13-17%

2 Plavix Vs ASA: is more effective than ASA by 7.3-8.7%

3 ASA+Dipyridamole Vs ASA: more effective than ASA by 20-23%

4 ASA+Dipyridamole Vs Plavix: similar to Plavix

5ASA+Plavix vs Plavix: No benefit, increase fatal bleeding, but reduce myocardial infarct

Clinical trial results of anticoagulation

2 year follow up      Event     Bleeding     Mortality     Net benefit outcome 

Warfarin (INR 2-3)      1.69%       0.38%         4.13%           7.64% 

Dabigatran 110 mg BID   1.53%       0.12%         3.75%           7.09%

Dabigatran 150 mg BID   1.11%       0.10%         3.64%           6.91%

Recommendations:

1.  Plavix or ASA plus Dipyridamole: First line treatment in 2nd prevention

2. ASA is the alternative if above not available or contraindicated or patient has no insurance

3. All of above is the first line options for the secondary prevention of stroke.

Recommendations in patient with A-Fib who has stroke:

1. 150 mg BID for pt at high risk of stroke

2. 110 mg BID for pt at high risk of bleeding or drug interaction

3. 75 mg BID for patient with renal failure (CrCl 15-30)

4. No need to switch if coumadin is using and well tolerated

 

加跟帖:

当前帖子已经过期归档,不能加跟帖!