もう怖くない!　心房細動の抗凝固療法

出版社： 文光堂
著者：
発行日： 2017-08-21
分野： 臨床医学：内科  >  循環器一般
ISBN： 9784830619397
電子書籍版： 2017-08-21 （第1版第1刷）
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心房細動は，現在日本に100万人以上いると推定されているcommon diseaseであり，プライマリ・ケア医も遭遇することの多い疾患である．心房細動では血栓が生じやすく，脳梗塞リスクの高い患者ではその予防のために抗凝固療法が必要であるが，出血リスクが高まるため，苦手としているプライマリ・ケア医が多い．本書では，自身もプライマリ・ケア医の現場に身を置く第一線の専門医が，心房細動の抗凝固療法を行ううえでプライマリ・ケア医が知っておくべき知識を余すところなく解説する．

目次

  • もう怖くない！　心房細動の抗凝固療法

    ―目次―

    序章　心房細動の基礎知識
    　1　心房細動のメカニズム
    　2　心房細動の疫学と予後
    　3　心房細動の分類
    　4　心房細動診療のロードマップ
    　5　心房細動の旅
    1章　抗凝固薬の基礎知識
    　1　凝固系の基礎知識
    　2　ワルファリンとNOAC
    　　コラム　NOAC，DOAC，どちらで呼ぶ？
    2章　抗凝固療法の基本的な考え方
    　1　抗凝固療法の超基本
    3章　脳塞栓症のリスク評価（A）
    　1　リスク評価の超基本
    　　コラム　「非弁膜症性」と「弁膜症性」の違いは？
    　2　CHADS2スコアの問題点
    　3　CHADS2スコア0,1点の低リスク例の適応はこう考える
    　　メモ　HAS-BLEDスコア
    　4　高齢者の適応はこう考える
    　　コラム　在宅認知症患者の現実世界を考える
    　5　 発作性心房細動の適応はこう考える
    4章　抗凝固薬の意思決定（D）
    　1　抗凝固薬意思決定の超基本
    　　コラム　患者中心の医療の方法と抗凝固薬
    5章　抗凝固薬の選び方（C）
    　1　薬理の比較
    　2　エビデンス，ガイドラインの比較
    　　a．RCT
    　　　コラム　大出血？ 頭蓋内出血？出血性脳卒中？
    　　b．リアルワールドデータ
    　　　コラム　リアルワールドデータはこう読む
    　　　コラム　用量設定からみた各NOACの強みと弱み
    　　c．ガイドライン
    　3　使い分け実践編?
    　　a．ワルファリンかNOACか？
    　　b．4つのNOACのどれを選ぶか？
    　　　メモ　TTRとは？
    　　　コラム　ワルファリン治療の人種差とSAMe-TT2R2スコア
    6章　抗凝固薬の管理（A）
    　1　抗凝固薬管理の基本8項目
    　2　ワルファリンの上手な使い方
    　　　コラム　脳出血，大出血，脳梗塞後の抗凝固薬の再開
    　3　NOACの上手な使い方
    　　a．モニタリング
    　　b．用量設定
    　　c．薬物相互作用
    　　d．NOAC服用中の出血への対処法
    　　e．ワルファリンとNOACの切り替え方
    　　　コラム　透析患者の抗凝固療法
    　4　抜歯，内視鏡，手術，除細動，アブレーション時の対処法
    　　a．抜歯
    　　b．内視鏡
    　　c．手術
    　　d．除細動
    　　e．カテーテルアブレーション
    　5　冠動脈疾患患者に対する抗凝固薬＋抗血小板薬の使い方
    　6　血圧管理
    　7　服薬アドヒアランス

    【診察室で便利な心房細動，抗凝固療法のお役立ち図表】
    ●心房細動の分類
    ●症状のある心房細動への対処法
    ●CHADS2スコア，CHA2DS2-VAScスコア
    ●抗凝固薬を誰に処方すべきか
    　・私案
    　・日本循環器学会ガイドライン
    ●HAS-BLEDスコア
    ●高齢者の抗凝固療法の考え方
    ●抗凝固療法における意思決定の手順
    ●各抗凝固薬の薬理学的特性比較一覧
    ●SAMe-TT2R2スコア
    ●各抗凝固薬の特徴比較一覧
    ●当院における抗凝固薬の使い分け
    ●Dr.Lipの提唱する抗凝固薬のシンプルな使い分け
    ●脳梗塞予防薬チェックシート
    ●ワルファリンの導入と維持
    ●PT-INR上昇時の管理アルゴリズム
    ●ワルファリンに影響を与える因子
    ●NOACのモニタリングの実際
    ●NOACの減量基準と禁忌（各薬剤添付文書より）
    ●腎機能とNOACの用量
    ●ワルファリンとNOACの切り替え方
    ●抗凝固薬服用者の内視鏡検査時のフローチャート
    ●外科的手技前のNOAC中止期間
    ●除細動時の抗凝固療法
    ●冠動脈疾患合併心房細動患者の抗血栓療法
    　・2016年ESCガイドライン
    　・2015年ヨーロッパ不整脈学会実践ガイド

この書籍の参考文献

参考文献のリンクは、リンク先の都合等により正しく表示されない場合がありますので、あらかじめご了承下さい。

本参考文献は電子書籍掲載内容を元にしております。

序章 心房細動の基礎知識

P.5 掲載の参考文献
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1章 抗凝固薬の基礎知識

P.29 掲載の参考文献
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2章 抗凝固療法の基本的な考え方

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3章 脳塞栓症のリスク評価 ( A )

P.47 掲載の参考文献
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P.48 掲載の参考文献
1) Raffaele De, et al. What is 'valvular' atrial fibrillation? A reappraisal. Eur Heart J 2014 ; 35 (47) : 3328-35.
 
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4) Avezum A, et al. Apixaban in Comparison With Warfarin in Patients With Atrial Fibrillation and Valvular Heart Disease : Findings From the Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation (ARISTOTLE) Trial. Circulation 2015 ; 132 (8) : 624-32.
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5) Akao M, et al. Current status of clinical background of patients with atrial fibrillation in a community-based survey : The Fushimi AF Registry. J Cardiol 2013 ; 61 (4) : 260-6.
 
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P.59 掲載の参考文献
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4章 抗凝固薬の意思決定 ( D )

P.88 掲載の参考文献
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5章 抗凝固薬の選び方 ( C )

P.109 掲載の参考文献
1) Hori M, et al. Dabigatran versus warfarin : effects on ischemic and hemorrhagic strokes and bleeding in asians and non-asians with atrial fibrillation. Stroke 2013 ; 44 (7) : 1891-6.
PubMed
2) Hori M, et al. Rivaroxaban vs. warfarin in Japanese patients with atrial fibrillation-the J-ROCKET AF study-. Circ J 2012 ; 76 (9) : 2104-11.
 
3) Goto S, et al. Efficacy and safety of apixaban compared with warfarin for stroke prevention in patients with atrial fibrillation from East Asia : a subanalysis of the Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation (ARISTOTLE) Trial. Am Heart J 2014 ; 168 (3) : 303-9.
PubMed
4) Yamashita T, et al. Edoxaban vs. Warfarin in East Asian Patients With Atrial Fibrillation-An ENGAGE AF-TIMI 48 Subanalysis. Circ J 2016 ; 80 (4) : 860-9.
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P.112 掲載の参考文献
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3) Connolly SJ, et al. Dabigatran versus warfarin in patients with atrial fibrillation. N Engl J Med 2009 ; 361 (12) : 1139-51.
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4) Patel MR, et al. Rivaroxaban versus warfarin in nonvalvular atrial fibrillation. N Engl J Med 2011 ; 365 (10) : 883-91.
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6章 抗凝固薬の管理 ( A )

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2) Akao M, et al. Current status of clinical background of patients with atrial fibrillation in a community-based survey : The Fushimi AF Registry. J Cardiol 2013 ; 61 (4) : 260-6.
 
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4) Dewilde WJ, et al. Use of clopidogrel with or without aspirin in patients taking oral anticoagulant therapy and undergoing percutaneous coronary intervention : an open-label, randomised, controlled trial. Lancet. 2013 ; 381 (9872) : 1107-15.
 
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6) Heidbuchel H, et al. Updated European Heart Rhythm Association Practical Guide on the use of non-vitamin K antagonist anticoagulants in patients with non-valvular atrial fibrillation. Europace 2015 ; 17 (10) : 1467-507.
 
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