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EUR HEART J-CARD PHA：房颤患者同时服用非维生素K拮抗剂、口服抗凝剂和抗癫痫药物的重大出血风险？

2020-08-01 MedSci原创 MedSci原创

口服抗凝剂；抗癫痫药物；出血风险
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本研究比较了房颤患者同时服用非维生素K拮抗剂、口服抗凝剂(NOACs)和抗癫痫药物(AEDs)与只服用NOACs的患者发生大出血的风险。

本研究比较了房颤患者同时服用非维生素K拮抗剂、口服抗凝剂(NOACs)和抗癫痫药物(AEDs)与只服用NOACs的患者发生大出血的风险。

研究人员使用台湾国民健康保险数据库进行了一项回顾性队列研究，纳入了2012年6月1日至2017年12月31日期间接受NOAC处方的AF患者。比较了接触NOAC和11例同期AEDs(卡马西平、加巴喷丁、拉莫三嗪、左乙拉西坦、奥卡西平、苯巴比妥、苯妥英、普雷巴林、托吡酯、丙戊酸、唑尼沙胺)的人和单独接触NOAC的人的主要出血风险。使用泊松回归模型通过治疗的逆概率加权来估计伴或不伴AEDs的NOAC的校正发生率差异。

在104 319名患者中（年龄75.0±10.3岁；男性，占56.2％），在731723人季度使用NOAC处方期间发生了8546例重大出血事件。 在NOAC治疗的患者中，同时使用AED占15.3％。 与丙戊酸，苯妥英钠或左乙拉西坦同时使用诺艾克，与单独使用诺艾克相比，每1000人年大出血的调整发生率显着增加：诺艾加丙戊酸为153.49，而单独诺艾卡为55.06 [差异98.43，95％置信区间 （CI）82.37–114.49]； NOAC加苯妥英钠为135.83，而单独的NOAC为54.43（差异81.4，95％CI 60.14-102.66）； NOAC加左乙拉西坦为132.96，而单独使用NOAC则为53.08（差异79.88，95％CI 64.47–95.30）。

研究结果表明，对于房颤患者，同时使用NOACs和丙戊酸、苯妥英或左乙拉西坦可增加大出血的风险。

原始出处：

Chun-Li Wang,  Victor Chien-Chia Wu,Assessing major bleeding risk in atrial fibrillation patients concurrently taking non-vitamin K antagonist oral anticoagulants and antiepileptic drugs

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    2021-04-14 shuangle

    #抗癫痫#

    0

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    2020-08-03 gdsun

    #口服抗凝剂#

    0

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    2020-08-03 cmsvly

    #大出血#

    0

  4. 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    2020-08-03 zhaojie88

    #ART#

    0

  5. 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    2020-08-03 mgqwxj

    #抗癫痫药物#

    0

  6. 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    2020-08-03 bsmagic9133

    #维生素K#

    0

  7. 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content=<a href='/topic/show?id=6732e9086af' target=_blank style='color:#2F92EE;'>#维生素k拮抗剂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79086, encryptionId=6732e9086af, topicName=维生素k拮抗剂)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Mon Aug 03 10:10:02 CST 2020, time=2020-08-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1511767, encodeId=59311511e6798, content=<a href='/topic/show?id=90d75628960' target=_blank style='color:#2F92EE;'>#拮抗剂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56289, encryptionId=90d75628960, topicName=拮抗剂)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=474c10379153, createdName=ms5236388012055669, createdTime=Mon Aug 03 10:10:02 CST 2020, time=2020-08-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1563348, encodeId=147d15633488a, content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=80d715270048, createdName=slcumt, createdTime=Mon Aug 03 10:10:02 CST 2020, time=2020-08-03, status=1, ipAttribution=)]
    2020-08-03 xirongguo

    #非维生素K拮抗剂#

    0

  8. 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createdBy=ed25376, createdName=gdsun, createdTime=Mon Aug 03 10:10:02 CST 2020, time=2020-08-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1316180, encodeId=85ee131618003, content=<a href='/topic/show?id=7a1c4360e6e' target=_blank style='color:#2F92EE;'>#大出血#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=43607, encryptionId=7a1c4360e6e, topicName=大出血)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=aad0444, createdName=cmsvly, createdTime=Mon Aug 03 10:10:02 CST 2020, time=2020-08-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1357579, encodeId=db49135e579e6, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, 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channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79083, encryptionId=8524e9083c6, topicName=维生素K)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ca0d3990423, createdName=bsmagic9133, createdTime=Mon Aug 03 10:10:02 CST 2020, time=2020-08-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1426110, encodeId=39e11426110f5, content=<a href='/topic/show?id=d91199616c9' target=_blank style='color:#2F92EE;'>#非维生素K拮抗剂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99616, encryptionId=d91199616c9, topicName=非维生素K拮抗剂)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=cb034034091, createdName=xirongguo, createdTime=Mon Aug 03 10:10:02 CST 2020, time=2020-08-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1436576, encodeId=811114365e65d, content=<a href='/topic/show?id=6732e9086af' target=_blank style='color:#2F92EE;'>#维生素k拮抗剂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79086, encryptionId=6732e9086af, topicName=维生素k拮抗剂)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Mon Aug 03 10:10:02 CST 2020, time=2020-08-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1511767, encodeId=59311511e6798, content=<a href='/topic/show?id=90d75628960' target=_blank style='color:#2F92EE;'>#拮抗剂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56289, encryptionId=90d75628960, topicName=拮抗剂)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=474c10379153, createdName=ms5236388012055669, createdTime=Mon Aug 03 10:10:02 CST 2020, time=2020-08-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1563348, encodeId=147d15633488a, content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=80d715270048, createdName=slcumt, createdTime=Mon Aug 03 10:10:02 CST 2020, time=2020-08-03, status=1, ipAttribution=)]
    2020-08-03 zhouqu_8

    #维生素k拮抗剂#

    0

  9. 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encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Mon Aug 03 10:10:02 CST 2020, time=2020-08-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1414715, encodeId=a2921414e151e, content=<a href='/topic/show?id=94a85555919' target=_blank style='color:#2F92EE;'>#抗癫痫药物#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=55559, encryptionId=94a85555919, topicName=抗癫痫药物)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=05ca3082114, createdName=mgqwxj, createdTime=Mon Aug 03 10:10:02 CST 2020, time=2020-08-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1425731, encodeId=52481425e31d5, content=<a href='/topic/show?id=8524e9083c6' target=_blank style='color:#2F92EE;'>#维生素K#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79083, encryptionId=8524e9083c6, topicName=维生素K)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ca0d3990423, createdName=bsmagic9133, createdTime=Mon Aug 03 10:10:02 CST 2020, time=2020-08-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1426110, encodeId=39e11426110f5, content=<a href='/topic/show?id=d91199616c9' target=_blank style='color:#2F92EE;'>#非维生素K拮抗剂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99616, encryptionId=d91199616c9, topicName=非维生素K拮抗剂)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=cb034034091, createdName=xirongguo, createdTime=Mon Aug 03 10:10:02 CST 2020, time=2020-08-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1436576, encodeId=811114365e65d, content=<a href='/topic/show?id=6732e9086af' target=_blank style='color:#2F92EE;'>#维生素k拮抗剂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79086, encryptionId=6732e9086af, topicName=维生素k拮抗剂)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Mon Aug 03 10:10:02 CST 2020, time=2020-08-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1511767, encodeId=59311511e6798, content=<a href='/topic/show?id=90d75628960' target=_blank style='color:#2F92EE;'>#拮抗剂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56289, encryptionId=90d75628960, topicName=拮抗剂)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=474c10379153, createdName=ms5236388012055669, createdTime=Mon Aug 03 10:10:02 CST 2020, time=2020-08-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1563348, encodeId=147d15633488a, content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=80d715270048, createdName=slcumt, createdTime=Mon Aug 03 10:10:02 CST 2020, time=2020-08-03, status=1, ipAttribution=)]
    2020-08-03 ms5236388012055669

    #拮抗剂#

    0

  10. [GetPortalCommentsPageByObjectIdResponse(id=1716058, encodeId=4abd1e160587d, content=<a href='/topic/show?id=a4175555e85' target=_blank style='color:#2F92EE;'>#抗癫痫#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=55557, encryptionId=a4175555e85, topicName=抗癫痫)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=695a32117432, createdName=shuangle, createdTime=Wed Apr 14 15:10:02 CST 2021, time=2021-04-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1309766, encodeId=14b81309e6645, content=<a href='/topic/show?id=886438210fb' target=_blank style='color:#2F92EE;'>#口服抗凝剂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=38210, encryptionId=886438210fb, topicName=口服抗凝剂)], attachment=null, authenticateStatus=null, createdAvatar=, 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encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Mon Aug 03 10:10:02 CST 2020, time=2020-08-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1414715, encodeId=a2921414e151e, content=<a href='/topic/show?id=94a85555919' target=_blank style='color:#2F92EE;'>#抗癫痫药物#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=55559, encryptionId=94a85555919, topicName=抗癫痫药物)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=05ca3082114, createdName=mgqwxj, createdTime=Mon Aug 03 10:10:02 CST 2020, time=2020-08-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1425731, encodeId=52481425e31d5, content=<a href='/topic/show?id=8524e9083c6' target=_blank style='color:#2F92EE;'>#维生素K#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79083, encryptionId=8524e9083c6, topicName=维生素K)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ca0d3990423, createdName=bsmagic9133, createdTime=Mon Aug 03 10:10:02 CST 2020, time=2020-08-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1426110, encodeId=39e11426110f5, content=<a href='/topic/show?id=d91199616c9' target=_blank style='color:#2F92EE;'>#非维生素K拮抗剂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99616, encryptionId=d91199616c9, topicName=非维生素K拮抗剂)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=cb034034091, createdName=xirongguo, createdTime=Mon Aug 03 10:10:02 CST 2020, time=2020-08-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1436576, encodeId=811114365e65d, content=<a href='/topic/show?id=6732e9086af' target=_blank style='color:#2F92EE;'>#维生素k拮抗剂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79086, encryptionId=6732e9086af, topicName=维生素k拮抗剂)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Mon Aug 03 10:10:02 CST 2020, time=2020-08-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1511767, encodeId=59311511e6798, content=<a href='/topic/show?id=90d75628960' target=_blank style='color:#2F92EE;'>#拮抗剂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56289, encryptionId=90d75628960, topicName=拮抗剂)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=474c10379153, createdName=ms5236388012055669, createdTime=Mon Aug 03 10:10:02 CST 2020, time=2020-08-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1563348, encodeId=147d15633488a, content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=80d715270048, createdName=slcumt, createdTime=Mon Aug 03 10:10:02 CST 2020, time=2020-08-03, status=1, ipAttribution=)]
    2020-08-03 slcumt

    #HEART#

    0

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