循環器ジャーナル68巻4号

2020年10月発行

特集 抗血栓療法—日常臨床での疑問に応える Ⅰ．心房細動に対する抗血栓療法

心房細動に対して抗凝固薬をどう使うか？—凝固マーカーから考える

著者： 長内宏之¹

所属機関： ¹公立陶生病院循環器内科

ページ範囲：P.596 - P.602

Point
・心房細動患者に対する抗凝固薬投与時の凝固マーカー測定の意義は，ワルファリンと直接作用型経口抗凝固薬（DOAC）で大きく異なる．
・ワルファリン内服中には定期的にPT-INR（prothrombin time-international normalized ratio）値を測定し用量調節を行うが，2020年改訂版の『不整脈薬物治療ガイドライン』で，従来とは管理目標の変更がなされている．
・DOAC内服中には定期的な採血による凝固マーカー測定は推奨されていないが，患者や状況によっては凝固マーカー測定が実臨床において有用となりうる可能性が指摘されており，今後の進展が期待される．

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