{"id":5910,"date":"2024-02-04T10:35:34","date_gmt":"2024-02-04T08:35:34","guid":{"rendered":"http:\/\/doctorexpres.ro\/?p=5910"},"modified":"2024-02-06T16:39:03","modified_gmt":"2024-02-06T14:39:03","slug":"anticoagulantele-vitale-in-prevenirea-accidentului-vascular-cerebral","status":"publish","type":"post","link":"https:\/\/doctorexpres.ro\/index.php\/2024\/02\/04\/anticoagulantele-vitale-in-prevenirea-accidentului-vascular-cerebral\/","title":{"rendered":"Anticoagulantele, vitale \u00een prevenirea accidentului vascular cerebral"},"content":{"rendered":"

Mai mult de patru din cinci pacien\u0163i cu accident vascular cerebral, care au avut antecedente de tulbur\u0103ri de ritm cardiac, nu au primit niciun medicament pentru sub\u0163ierea s\u00eengelui sau nu au luat o doz\u0103 suficient\u0103 pentru a putea preveni eficient AVC-ul, \u00eenainte de a avea loc, sugereaz\u0103 un studiu american. <\/span><\/span><\/span><\/p>\n

Cele mai multe accidente vasculare cerebrale<\/a> apar atunci c\u00eend un cheag blocheaz\u0103 o arter\u0103 care transport\u0103 s\u00eengele la creier \u015fi s\u00eent cunoscute sub numele de accidente vasculare cerebrale ischemice. Studiul s-a axat pe mai mult de 94.000 de pacien\u0163i cu AVC cu fibrila\u0163ie atrial\u0103 (b\u0103t\u0103i rapide neregulate, care pot duce la AVC, insuficien\u0163\u0103 cardiac\u0103<\/a> \u015fi oboseal\u0103 cronic\u0103<\/a>). <\/span><\/span><\/span><\/p>\n

Heparina sau warfarina prelungesc timpul necesar pentru formarea cheagurilor<\/span><\/span><\/span><\/h6>\n

\u00cenainte de a suferi un AVC, doar 16% dintre ace\u015fti pacien\u0163i cu fibrila\u0163ie atrial\u0103 au luat doze adecvate de anticoagulante, cum ar fi heparina sau warfarina, care prelungesc timpul necesar pentru formarea cheagurilor \u00een s\u00eenge<\/a>, sau anticoagulante mai noi, cum ar fi dabigatran, rivaroxaban sau apixaban. <\/span><\/span><\/span><\/p>\n

\u201ePacien\u0163ii cu fibrila\u0163ie atrial\u0103 care nu iau anticoagulante sau care iau anticoagulante inadecvate prezint\u0103 un risc crescut de accident vascular cerebral<\/em>\u201d, a spus autorul principal al studiului, dr. Ying Xian, cercet\u0103tor neurolog la Duke University Medical Center din Durham, Carolina de Nord. <\/span><\/span><\/span><\/p>\n

\u201eChiar \u0219i \u00een cazurile rare, \u00een care terapia anticoagulant\u0103 nu a reu\u0219it s\u0103 previn\u0103 un AVC, pacien\u021bii care au luat anticoagulante mai noi sau warfarin\u0103 au prezentat un risc de AVC sever cu 35 p\u00een\u0103 la 44% mai mic, probabilitatea de deces<\/a> a fost cu cu 21-25% mai mic\u0103, iar \u015fansele de a func\u0163iona independent dup\u0103 AVC au fost cu 40-50% mai mari<\/em>\u201d, a ad\u0103ugat Xian. <\/span><\/span><\/span><\/p>\n

\u00cen fibrila\u0163ia atrial\u0103, impulsurile electrice din camerele superioare ale inimii <\/a>s\u00eent haotice, determin\u00eend acea parte a mu\u015fchiului inimii s\u0103 tremure, mai degrab\u0103 dec\u00eet s\u0103 se contracte normal. Ca urmare, s\u00eengele<\/a> nu se mi\u015fc\u0103 la fel de bine spre camerele inferioare ale inimii. Acest lucru poate duce la formarea de cheaguri care pot ajunge apoi \u00een artere<\/a>. Pacien\u0163ii cu fibrila\u0163ie atrial\u0103 au de p\u00een\u0103 la \u0219apte ori mai multe \u015fanse de a suferi un AVC<\/a> dec\u00eet cei f\u0103r\u0103 aceast\u0103 tulburare. \"3159348A00000578-3452517-image-m-6_1455818141359\"<\/span><\/span><\/span><\/p>\n

Fibrila\u0163ia atrial\u0103 face ca un AVC s\u0103 fie de p\u00een\u0103 la cinci ori mai probabil \u0219i reprezint\u0103 cauza a p\u00een\u0103 la 15% din totalul cazurilor de AVC<\/a> ischemic. <\/span><\/span><\/span><\/p>\n

Pentru a vedea c\u00eet de des pacien\u0163ii cu fibrila\u0163ie atrial\u0103 au luat anticoagulante, Xian \u015fi colegii s\u0103i au analizat datele referitoare la pacien\u0163ii spitaliza\u0163i pentru AVC \u00een perioada\u00a0 \u00een 1.622 de spitale americane. Pacien\u021bii au avut aproximativ 80 de ani, \u00een medie, \u0219i mai mult de jum\u0103tate au fost femei. Aproximativ 40% dintre pacien\u0163i au primit terapie antiplachetar\u0103, cum ar fi aspirina<\/a>, \u00een loc de anticoagulante<\/a>, \u00eenainte de AVC-ul lor, iar 30% nu au luat niciun tratament anticoagulant.<\/span><\/span><\/span><\/p>\n

Este nevoie de teste de laborator<\/h6>\n

Riscul de reac\u021bii adverse poate explica par\u021bial utilizarea limitat\u0103 a anticoagulantelor. Utilizarea pe termen lung a warfarinei, de exemplu, poate cre\u0219te riscul de s\u00eengerare sever\u0103, \u0219i este nevoie de teste de laborator <\/a>frecvente pentru a fi siguri c\u0103 pacien\u021bii iau doza corect\u0103. Anticoagulantele mai noi s\u00eent asociate cu mai pu\u021bine complica\u021bii hemoragice severe dec\u00eet warfarina, dar acest medicament poate avea complica\u021bii grave, cum ar fi arsurile la stomac<\/a> severe, grea\u021b\u0103 sau v\u0103rs\u0103turi. <\/span><\/span><\/span><\/p>\n

O limitare a studiului este c\u0103 \u00eei lipse\u0219te un grup de control de pacien\u0163i cu fibrila\u0163ie atrial\u0103 care nu au avut AVC. <\/span><\/span><\/span><\/p>\n

Cu toate acestea, rezultatele sugereaz\u0103 c\u0103 mai mult de 88.000 AVC-uri ar putea fi prevenite \u00een fiecare an, dac\u0103 persoanele cu fibrila\u0163ie atrial\u0103 ar lua dozele de anticoagulante recomandate, a spus Xian. <\/span><\/span><\/span><\/p>\n

\u201e\u00cen timp ce unii dintre pacien\u021bii din acest studiu au avut motive legitime s\u0103 evite terapia antitrombotic\u0103, aceast\u0103 rat\u0103 extrem de sc\u0103zut\u0103 de aplicare a tratamentului eficient pentru prevenirea AVC-ului este deconcertant\u0103<\/em>\u201d, a spus cardiologul Samuel Wann. <\/span><\/span><\/span><\/p>\n

Lipsa de con\u0219tientizare este o parte a problemei, a declarat dr. Jonathan Hsu, cardiolog la Universitatea din California, San Diego. <\/span><\/span><\/span>\u201eCu toate c\u0103 un anticoagulant oral este un medicament cu risc de s\u00eengerare, multe studii au ar\u0103tat c\u0103 reducerea riscului de accident vascular cerebral dep\u0103\u0219e\u0219te riscul de s\u00eengerare la marea majoritate a pacien\u0163ilor cu fibrila\u0163ie atrial\u0103<\/em>\u201d, a declarat Hsu. <\/span><\/span><\/span><\/p>\n

Sursa: reuters.com<\/a><\/span><\/span><\/span><\/p>\n","protected":false},"excerpt":{"rendered":"

Mai mult de patru din cinci pacien\u0163i cu accident vascular cerebral, care au avut antecedente de tulbur\u0103ri de ritm cardiac,<\/p>\n","protected":false},"author":4,"featured_media":5911,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_exactmetrics_skip_tracking":false,"_exactmetrics_sitenote_active":false,"_exactmetrics_sitenote_note":"","_exactmetrics_sitenote_category":0,"footnotes":""},"categories":[96,818,91,103],"tags":[8197,8200,7265,217,1550,8202,8210,6428,8201,8198,424,2498,8208,8205,1824,8203,8209,8211,8206,8207,8199,8204],"class_list":["post-5910","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-boli","category-creier-si-sistem-nervos","category-stiri","category-varstnici","tag-accident-vascular-cerebral-ischemic","tag-anticoagulante","tag-aspirina","tag-avc","tag-cheag-de-sange","tag-dabigatran","tag-dr-jonathan-hsu","tag-fibrilatie-atriala","tag-formarea-cheagurilor-de-sange","tag-heparina","tag-insuficienta-cardiaca","tag-oboseala-cronica","tag-prevenire-avc","tag-risc-de-avc","tag-risc-de-deces","tag-rivaroxaban","tag-samuel-wann","tag-terapia-antitrombotica","tag-terapie-antiplachetara","tag-tratament-anticoagulant","tag-warfarina","tag-ying-xian"],"yoast_head":"\nAnticoagulantele, vitale \u00een prevenirea accidentului vascular cerebral - Doctor Expres<\/title>\n<meta name=\"description\" content=\"Mai mult de patru din cinci pacien\u0163i\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/doctorexpres.ro\/index.php\/2024\/02\/04\/anticoagulantele-vitale-in-prevenirea-accidentului-vascular-cerebral\/\" \/>\n<meta property=\"og:locale\" content=\"ro_RO\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Anticoagulantele, vitale \u00een prevenirea accidentului vascular cerebral - Doctor Expres\" \/>\n<meta property=\"og:description\" content=\"Mai mult de patru din cinci pacien\u0163i\" \/>\n<meta property=\"og:url\" content=\"https:\/\/doctorexpres.ro\/index.php\/2024\/02\/04\/anticoagulantele-vitale-in-prevenirea-accidentului-vascular-cerebral\/\" \/>\n<meta property=\"og:site_name\" content=\"Doctor Expres\" \/>\n<meta property=\"article:published_time\" content=\"2024-02-04T08:35:34+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2024-02-06T14:39:03+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/doctorexpres.ro\/wp-content\/uploads\/2017\/03\/stroke-patients-570x350.jpg\" \/>\n\t<meta property=\"og:image:width\" content=\"460\" \/>\n\t<meta property=\"og:image:height\" content=\"277\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"author\" content=\"Doctor Expres\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Scris de\" \/>\n\t<meta name=\"twitter:data1\" content=\"Doctor Expres\" \/>\n\t<meta name=\"twitter:label2\" content=\"Timp estimat pentru citire\" \/>\n\t<meta name=\"twitter:data2\" content=\"5 minute\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\/\/doctorexpres.ro\/index.php\/2024\/02\/04\/anticoagulantele-vitale-in-prevenirea-accidentului-vascular-cerebral\/#article\",\"isPartOf\":{\"@id\":\"https:\/\/doctorexpres.ro\/index.php\/2024\/02\/04\/anticoagulantele-vitale-in-prevenirea-accidentului-vascular-cerebral\/\"},\"author\":{\"name\":\"Doctor Expres\",\"@id\":\"https:\/\/doctorexpres.ro\/#\/schema\/person\/28f79c329d023ab5816a649c97121076\"},\"headline\":\"Anticoagulantele, vitale \u00een prevenirea accidentului vascular cerebral\",\"datePublished\":\"2024-02-04T08:35:34+00:00\",\"dateModified\":\"2024-02-06T14:39:03+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\/\/doctorexpres.ro\/index.php\/2024\/02\/04\/anticoagulantele-vitale-in-prevenirea-accidentului-vascular-cerebral\/\"},\"wordCount\":756,\"image\":{\"@id\":\"https:\/\/doctorexpres.ro\/index.php\/2024\/02\/04\/anticoagulantele-vitale-in-prevenirea-accidentului-vascular-cerebral\/#primaryimage\"},\"thumbnailUrl\":\"https:\/\/doctorexpres.ro\/wp-content\/uploads\/2017\/03\/stroke-patients-570x350.jpg\",\"keywords\":[\"accident vascular cerebral ischemic\",\"anticoagulante\",\"aspirina\",\"avc\",\"cheag de sange\",\"dabigatran\",\"dr. 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