JACC:房颤患者使用利伐沙班 出血和卒中发生率如何?

2018-10-12 王淳 环球医学

2018年7月,发表在《J Am Coll Cardiol》的一项由英国、迪拜、韩国、智利等国学者进行的分析,评估了利伐沙班治疗的房颤患者的出血和卒中发生情况。

2018年7月,发表在《J Am Coll Cardiol》的一项由英国、迪拜、韩国、智利等国学者进行的分析,评估了利伐沙班治疗的房颤患者的出血和卒中发生情况。

背景:直接口服抗凝药(DOAC)进行房颤患者卒中预防的有效性还未在临床试验中明确。然而,需要良好设计的有关DOAC安全性和有效性的前瞻性真实世界观察性研究。

目的:本研究旨在对纳入到全球XANTUS项目(Xarelto预防房颤患者卒中)中的房颤患者进行汇总分析,以评估利伐沙班的真实世界安全性特征。

方法:对XANTUS、XANAP(Xarelto预防亚洲房颤患者卒中)、XANTUS-EL(Xarelto预防拉丁美洲和EMEA地区房颤患者卒中)注册进行了预先计划的汇总分析。新开始利伐沙班预防卒中的房颤患者随访了1年。首要结局为治疗中出现的大出血、不良事件(AE)/严重AE和全因死亡。次要结局包括治疗中出现的血栓栓塞事件和非大出血。主要结局进行集中判定。

结果:总体来说,纳入了11121名患者(平均70.5±10.5岁,女性42.9%)。合并症包括心衰(21.2%)、高血压(76.2%)、糖尿病(22.3%)。事件发生率(事件/100患者年)分别为:大出血1.7(95% CI,1.5~2.0;最低是拉丁美洲,0.7;最高是西欧、加拿大和以色列,2.3);全因死亡1.9((95% CI,1.6~2.2;最低是东欧,1.5;最高是拉丁美洲、中东、非洲,2.7);卒中或全身性栓塞1.0(95% CI,0.8~1.2;最低是拉丁美洲,0;最高是东亚,1.8)。1年治疗依从性为77.4%(最低是东亚,66.4%;最高是东欧,84.4%)。

结论:这项对47个国家11121名患者进行的大型前瞻性真实世界分析显示,利伐沙班治疗的房颤患者具有较低的出血和卒中发生率,世界不同地区的停止治疗率较低。不同地区的结果大致一致。

原始出处:

Kirchhof P,et al. Global Prospective Safety Analysis of Rivaroxaban. J Am Coll Cardiol. 2018 Jul 10;72(2):141-153. doi: 10.1016/j.jacc.2018.04.058.

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    2018-12-10 hbwxf
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    2018-10-12 健健

    卒中虽然是临床上常见病,溶栓,取栓等血管内治疗也很成熟,但是仍然有很多未知问题有待认知!

    0

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    2018-10-12 王秀

    学习了,涨知识了!

    0

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