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Eur Heart J:接受不同口服抗凝药治疗的房颤患者骨折风险

2020-02-02 xing.T MedSci原创

由此可见,与华法林相比,NOAC与AF患者的骨折风险降低有关。因此,如果需要口服抗凝药,则应考虑使用NOAC而非华法林来降低骨折的风险。但是,需要进一步的研究来调查潜在的机制并阐明因果关系。

近日,心血管领域权威杂志Eur Heart J上发表了一篇研究文章,该研究旨在评估接受非维生素K拮抗剂口服抗凝剂(NOAC)或华法林治疗的房颤(AF)患者骨折风险。

研究人员使用台湾的国家健康保险研究数据库在全国范围内进行了回顾性的队列研究。研究纳入了台湾地区2012年至2016年之间新诊断并接受了NOAC或华法林治疗的所有AF患者,并随访至2017年。根据所使用的NOAC,将接受NOAC治疗的患者分为亚组(达比加群、利伐沙班和阿哌沙班)。研究人员进行了倾向得分匹配一进行一对一比较,并使用Cox回归分析计算出髋部、椎体以及肱骨/前臂/腕部骨折的调整后风险比(aHRs)。

匹配后,该研究纳入了19414例患者(每个NOAC和华法林组中分别有9707例)。中位随访时间为2.4年。与华法林相比,NOACs降低了骨折风险[aHR=0.84,95%置信区间(CI)=0.77-0.93;P<0.001]。亚组分析​​显示每个NOAC,即达比加群(aHR=0.88,95%CI=0.78-0.99; P=0.027)、利伐沙班(aHR=0.81,95%CI=0.72-0.90; P<0.001)和阿哌沙班( aHR=0.67,95%CI=0.52-0.87; P=0.003),均可使骨折风险降低。纳入所有符合条件患者(没有进行倾向得分匹配)的分析得到了相似的结果。

由此可见,与华法林相比,NOAC与AF患者的骨折风险降低有关。因此,如果需要口服抗凝药,则应考虑使用NOAC而非华法林来降低骨折的风险。但是,需要进一步的研究来调查潜在的机制并阐明因果关系。

原始出处:


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    2020-02-04 zhaojie88
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    2020-02-04 slcumt
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    2020-02-02 心介

    房颤,临床上碰到很多哦

    0

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