Zusammenfassung
Vorhofflimmern ist eine häufige Rhythmusstörung, die das Risiko eines Schlaganfalles deutlich erhöht. Insbesondere ältere Patienten, Patienten mit arterieller Hypertonie, Diabetes mellitus, Herzinsuffizienz, Schlaganfällen oder transitorisch ischämischen Attacken in der Anamnese sind gefährdet. Diese Patienten profitieren von einer Antikoagulations-Therapie, wobei ein INR von zirka 2,5 angestrebt werden muss. Direkte Thrombin-Inhibitoren scheinen in der Schlaganfall-Prophylaxe ähnlich wirksam zu sein wie Cumarine.
Summary
Atrial fibrillation is a common arrhythmia which increases the risk of stroke considerably. Risk factors for stroke include: age, arterial hypertension, heart failure, diabetes and a history of stroke. Patients with atrial fibrillation and risk factors for stroke benefit form anticoagulation therapy with an INR target of 2,5. First data indicate that direct thrombin antagonist are as effective as warfarin in the prevention of stroke in patients with atrial fibrillation.
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1 CHADS2 = Akronym für die Risikofaktoren Congestive heart failure, Hypertension, Age, Diabetes mellitus, Stroke oder TIA und ihrem Punktwert.
2 AFFIRM = Atrial Fibrillation Follow-up Investigation of Rhythm Management
3 SPORTIF III = Schlaganfall-Prävention durch einen oralen Thrombin-Inhibitor bei atrialer Fibrillation
Anschrift des Verfassers
PD Dr. Christian Schneider
Klinik III für Innere Medizin, Universität zu Köln
Joseph-Stelzmann Straße 9
50924 Köln
Fax: 0221/4783673
Email: christian.schneider@medizin.uni-koeln.de
