Korean Journal of Stroke 2012 ; 14 (3) : p.106~115
Focused Update on Primary Stroke Prevention in Patients with Atrial Fibrillation in Korean Clinical Practice Guidelines for Stroke
(한국 뇌졸중 진료지침에서 심방세동 환자의 뇌졸중 일차예방에 관한 내용의 부분 개정)
저자 박종무1,홍근식2·한상원3·김한영4·조용진2·강규식1·유경호5·나정호6·허지회7·권순억8·오창완9·배희준10·이병철5·윤병우10·구자성11
논문 종류 Clinical Practice Guideline 전문 보기 KJS-14-106-115.pdf
Pivotal clinical trials testing the efficacy of new antithrombotics for the prevention of stroke and systemic embolism in patients with atrial fibrillation have been published since the release of the first edition of Korean clinical practice guidelines for primary stroke prevention. From July 2007 to August 2012, 5 clinical studies and update of guidelines in Europe and North America were identified through systematic search. In patients with atrial fibrillation who were unsuitable for warfarin, the combination of clopidogrel and aspirin reduced the risk of stroke at the cost of increased major bleedings as compared to aspirin. In patients with nonvalvular atrial fibrillation and risk factors for stroke, new oral anticoagulants, dabigatran, rivaroxaban and apixaban, were as effective as or more effective than warfarin in preventing stroke or systemic embolism. The risks of major bleeding with novel anticoagulants were similar to or lower than that of warfarin. Particularly, the risk of intracranial bleeding was significantly lower with novel anticoagulants than with warfarin. In this report, we summarized the new evidences and updated our recommendations for primary stroke prevention in patients with atrial fibrillation. (Korean J Stroke 2012;14:106-115)

KEY WORDS: Stroke, Practice guideline, Primary prevention, Atrial fibrillation, Antithrombotic therapy