7
शषԣ
ط
ञָᛌ੩ّԽɻ
፮ࠓ
68%
e
ԅფcָᛌ੩ّɻ࡚Ԓ͂
ځ
̇ʞ׳c࡚Ԓ͂ജؒ׳
དԉՙj
2008
αਝ
ACC/AHA
ʑޫᔢԾผͳઐˮ
ȹ
ڈ
ᕾᇐञָᛌ੩ّ
ؿ
፮ʗᄙിʗ
ٲ
CHADS2
Щ
ʶঞ
Cardiac failure
cঢ়϶Ꭶ
Hypertension
cαᙍ
Age
c
ጅѭञ
Diabetes
cԽɻ
Stroke
Doubled
ӮɎ
ܞ፮ࠓ
ᅟ
ʗᅕ
ܫ
֡τԽɻ
/TIA
̌
2
αᙍÖ
75
ั
1
ঢ়϶Ꭶ
1
ጅѭञ
1
ʶɈঞေ
1
ߗ
ዶʗ
ݯ
0
c˿͂
ځ
̇ʞ׳དԉhዶʗ
ݯ
1
c˿͂
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2
c
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2
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4
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̦Ꮆ͂ജؒ׳དԉc˿ੴ੩ّᎶ͂ȿҊ
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ځ
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А
፮ࠓ
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ߗ
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϶ॖሔd϶ɩಕʭÕ
50
Ñ
103/m1
d϶ᎦÖ
160/
90mmHg
dɺᗙցࣂᏎಡቷ϶㢓ʏਝᅟๅʝˈଅ
INR
ّяɺ˿Ԛ͂ജؒ׳eɣ൴மৈc͂Έိ
˅ːֶ˱ࢀ
מ
ೕ́̔ඬ
ؿ
༜৽ّcΕ̰˾
Ԓΐॖ
ک
ɖɺփԚ͂ജؒ׳c˞Лʵɣˮ϶
ؿ
፮e
ঢ়ᙍָܰᛌ੩ّೕ́ॠ϶ֲԽɻ
ؿ
፮ΐॖcࣂ
ɖܰᎶ͂ജؒ׳Ҋቷʵೕˮ϶
ؿ
ዟ͓፮ΐॖe
ߗ
ॶ
ੀ
INR
ઁԹΕ
2
ã
3
ɾංᎶܰΪͲ
ؿ
eྦྷ
75
ั˞ɐ੩
ّਝɐ
ۺ
ᘪ
INR
ઁԹΕ
1.6-2.5
ҡ
ݯ
ଉe
2009
αਝ
ACC
αผɐʔЗ
ؿ
ACTIVE-A
ޢ
Ӡొˮྦྷ
כ
ȹԒɺॶԚ͂ЎɌ̦Ԛ͂ജؒ׳
੩ؿ
ّcɖ˿Ε
Ꮆ͂
ځ
̇ʞ׳
ؿ
ਥᓣɐ˱͂ಉ㢓ࣟཊ౧ˤc˿ొঢ়௰
͂
ځ
̇ʞ׳
ࠌ
ГԽɻ
ؿ፮ࠓ
དԉࢽ
28%
cЎˮ϶
፮ࠓ
ɖႦ۹ᄈ˱c˱ੜဟಡe
WHY DO THEY HAVE CEREBRAL INFARCTS?
A cerebral infarct may be a "transient ischemic attack" (TIA), or classified as "minor stroke" or "major stoke", accordingly. AF
(atrial fibrillation) is quivering of the atrial chamber of the heart rather than the regular rhythmic contractions. Blood flow slows
down; blood clots may form - brain infarct eventually occurs if clots are dislodged, clogging the brain arteries. AF is progressively
commoner in the elderly;, the risk of stroke for untreated chronic AF is 5%/year. Pooled analysis showed that Warfarin, an oral
blood thinning agent, lowers such risks by 68% in AF patients without valve pathology. Warfarin is better than aspirin in prevent-
ing strokes in AF patients - if there is history of stroke or TIAs, or, if there are >1 of these factors: age >75, hypertension, diabetes,
heart failure, Warfarin instead of aspirin must be used. Those elderly patients with low platelet counts (<50x109/L), hypertension;
unwilling to have regular INR blood tests, alcoholics, frequent pain killer usage, high-risk athletes, etc., should also avoid Warfarin
- the 2009 ACTIVE-A Study showed that Aspirin + Clopidogrel would also reduce the risk of strokes by 28%, compared to only
Aspirin.
