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Int J Cardiol:肥厚型心肌病伴房颤患者采用直接口服抗凝剂治疗效果如何?

2017-08-15 xing.T MedSci原创

由此可见,HCM伴房颤患者采用NOACs治疗显示类似的栓塞和出血发生率,相比于VKA治疗。虽然两组患者生活质量相似,采用NOAC治疗组的患者报道的治疗满意度更高。

采用维生素K拮抗剂(VKAs)进行长期抗凝治疗被推荐用于肥厚性心肌病(HCM)和心房颤动患者的治疗。直接口服抗凝剂(NOACs)是一种VKAs的替代药物,但有有限的数据支持它们在HCM患者中的使用。近日,心血管领域权威杂志International Journal of Cardiology上发表了一篇研究文章,研究人员旨在描述HCM伴房颤患者采用NOACs治疗的使用方式、出血和血栓栓塞事件以及生活质量。

采用NOACs(n=99)和VKA(n=433)治疗的患者数据来自于9个遗传性心脏病中心,通过回顾性收集获得。研究人员分析并比较了栓塞事件、严重出血和死亡的每年方式率。采用SF-36和SAFUCA问卷调查评估了80名采用NOAC治疗和57名采用VKA治疗的患者的生活质量和治疗满意度。

该研究平均随访63个月(IQR:26-109),血栓栓塞事件(TIA或卒中和外周动脉栓塞)在10%的口服抗凝药的患者中发生。主要/临床相关出血发生率为3.8%,整体死亡率为23.3%。血栓栓塞事件的发生率在NOAC组患者为每100名患者每年0.62人,在VKA组患者为1.59人[亚风险比为0.32;95%可信区间为0.04-2.45;P=0.27]。主要/临床相关的出血发生率在NOAC组患者为每100名患者每年0.62人,在VKA组患者为0.60人[亚风险比为1.28;95%可信区间为0.18-9.30;P=0.85)。生活质量评分在两组较为类似;然而,NOAC治疗的患者在SAFUCA中取得了更高的分数。

由此可见,HCM伴房颤患者采用NOACs治疗显示类似的栓塞和出血发生率,相比于VKA治疗。虽然两组患者生活质量相似,采用NOAC治疗组的患者报道的治疗满意度更高。

原始出处:


FernandoDominguez,et al. Direct oral anticoagulants in patients with hypertrophic cardiomyopathy and atrial fibrillation. https://doi.org/10.1016/j.ijcard.2017.08.010

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createdBy=74421964351, createdName=ishtar, createdTime=Tue Aug 15 19:22:22 CST 2017, time=2017-08-15, status=1, ipAttribution=)]
    2017-08-16 1e145228m78(暂无匿称)

    学习了,谢谢作者分享!

    0

  8. 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createdBy=74421964351, createdName=ishtar, createdTime=Tue Aug 15 19:22:22 CST 2017, time=2017-08-15, status=1, ipAttribution=)]
    2017-08-15 1e145228m78(暂无匿称)

    学习了,谢谢作者分享!

    0

  9. 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createdBy=74421964351, createdName=ishtar, createdTime=Tue Aug 15 19:22:22 CST 2017, time=2017-08-15, status=1, ipAttribution=)]
    2017-08-15 ishtar

    近期几个大型研究对NOAC褒贬不一

    0

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