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Stroke:无房颤的DVT/PE患者直接口服抗凝血剂与华法林的颅内出血风险

2018-07-10 xing.T MedSci原创

由此可见,DVT/PE患者就ICH风险而言,DOAC相比于华法林具有更高的安全性。

深静脉血栓形成(DVTs)是一种常见疾病,如果发展为肺栓塞(PE),其发病率很高。抗凝治疗是治疗方法之一;长期以来华法林一直被作为标准治疗药物。直接口服抗凝剂(DOAC)的早期经验表明这些药物可能是治疗DVT/PE的更安全和同等有效的替代药物。非创伤性颅内出血(ICH)是抗凝治疗中最具破坏性的潜在并发症之一。近日,卒中领域权威杂志Stroke上发表了一篇研究文章,研究人员试图比较采用DOAC治疗与采用华法林治疗的DVT/PE患者ICH的发生率。

研究人员使用了MarketScan商业索赔和Medicare补充数据库的数据。研究人员对没有已知的房颤并且服用DOAC或华法林的成年DVT/PE患者随访至ICH住院,并使用精确匹配来平衡治疗组。研究人员使用Cox比例风险回归和Kaplan-Meier生存曲线来估计DOAC和华法林相比与ICH风险之间的关联。

由218620名患者组成的联合队列,其中位随访时间为3.0个月,平均年龄为55.4岁,女性占52.1%。DOAC队列有26980名患者和8次ICH事件(每1000人每年出现1个病例),华法林组有191640名患者和324次ICH事件(每1000人每年出现3.3个病例; P<0.0001)。Cox比例风险回归分析显示与华法林相比,DOAC队列在不匹配(风险比=0.26; P=0.0002)和匹配(风险比=0.20; P=0.0001)发生ICH的风险均较低。

由此可见,DVT/PE患者就ICH风险而言,DOAC相比于华法林具有更高的安全性。

原始出处:


Layton Lamsam,et al. Intracranial Hemorrhage in Deep Vein Thrombosis/Pulmonary Embolus Patients Without Atrial Fibrillation Direct Oral Anticoagulants Versus Warfarin.Stroke. 2018. https://doi.org/10.1161/STROKEAHA.118.022156

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    2018-12-29 feather89
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    2018-08-25 膀胱癌
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    2019-06-24 爆笑小医

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