JACC Clin Electrophysiol:多种疾病继发的房颤抗凝治疗及缺血性脑卒中和出血的风险

2018-08-11 MedSci MedSci原创

本研究旨在确定急性冠状动脉综合征(ACS),急性肺病或败血症发生的新发性继发性心房颤动(AF)患者的抗凝是否与缺血性卒中减少或出血风险增加有关。采用回顾性研究设计,确定了2,304名年龄在65岁或以上的患者,住院时主要诊断为ACS,急性肺病(慢性阻塞性肺病,肺炎/流感,肺栓塞或胸腔积液)或败血症,并发症1999年至2015年入院时新发房颤。在大约3年的随访中,我们没有发现抗凝治疗与发生ACS,急性

本研究旨在确定急性冠状动脉综合征(ACS),急性肺病或败血症发生的新发性继发性心房颤动(AF)患者的抗凝是否与缺血性卒中减少或出血风险增加有关。

采用回顾性研究设计,确定了2,304名年龄在65岁或以上的患者,住院时主要诊断为ACS,急性肺病(慢性阻塞性肺病,肺炎/流感,肺栓塞或胸腔积液)或败血症,并发症1999年至2015年入院时新发房颤

在大约3年的随访中,我们没有发现抗凝治疗与发生ACS,急性肺病或败血症的新发房颤患者的缺血性卒中发生率之间存在任何关联(校正混杂因子后,优势比[OR]:1.22,[95%置信区间(CI):0.65至2.27],OR:0.97 [95%CI:0.53至1.77],OR:1.98 [95%CI:0.29至13.47])。然而,抗凝治疗与急性肺病相关的房颤患者出血风险较高相关(OR:1.72 [95%CI:1.23-2.39]),而ACS或败血症则无此关系(OR:1.42 [95%CI: 0.94至2.14],OR:0.96 [95%CI:0.29至3.21])。

综上所述,该研究结果表明,继发性房颤的抗凝治疗效果不强,可能与出血风险增加有关。这些患者需要对抗凝治疗进行仔细的个人评估。

原始出处:

Quon MJ, Behlouli H, Pilote L. Anticoagulant Use and Risk of Ischemic Stroke and Bleeding in Patients With Secondary Atrial Fibrillation Associated With Acute Coronary Syndromes, Acute Pulmonary Disease, or Sepsis. JACC Clin Electrophysiol. 2018 Mar;4(3):386-393. doi: 10.1016/j.jacep.2017.08.003. Epub 2017 Sep 27.

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    2019-03-11 hbwxf
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    2019-02-27 feifers
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  5. 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  6. 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  7. 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time=2018-08-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1325930, encodeId=db8d13259300d, content=<a href='/topic/show?id=96c71804b7' target=_blank style='color:#2F92EE;'>#ACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=16, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1804, encryptionId=96c71804b7, topicName=ACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1e452500029, createdName=12498568m50暂无昵称, createdTime=Mon Aug 13 07:56:00 CST 2018, time=2018-08-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1026127, encodeId=51df102612ecf, content=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!, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=健健, createdTime=Sat Aug 11 19:56:00 CST 2018, time=2018-08-11, status=1, ipAttribution=)]
    2018-08-13 131****1460

    学习了受益匪浅

    0

  8. 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objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54263, encryptionId=a7385426313, topicName=房颤抗凝)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8df129768056, createdName=xiongke020, createdTime=Fri Dec 28 05:56:00 CST 2018, time=2018-12-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1788862, encodeId=a18c1e888628a, content=<a href='/topic/show?id=866d1421e4c' target=_blank style='color:#2F92EE;'>#Physio#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=17, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14217, encryptionId=866d1421e4c, topicName=Physio)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c689267, createdName=cmj8wellington, createdTime=Fri May 10 02:56:00 CST 2019, time=2019-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1893087, encodeId=0d58189308e75, content=<a href='/topic/show?id=c738e93521f' target=_blank style='color:#2F92EE;'>#缺血性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79352, encryptionId=c738e93521f, topicName=缺血性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=66ec123, createdName=guihongzh, createdTime=Sun Apr 28 08:56:00 CST 2019, time=2019-04-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=338369, encodeId=b47c3383691b, content=学习了受益匪浅, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLDicHg2ldsSNmib46PmdzpO7CQEmPjuULp1v45zPWwMYhrnXgvl3OtmUCZSQfgITWn96X9moL94nUGA/0, createdBy=28072041016, createdName=131****1460, createdTime=Mon Aug 13 19:08:51 CST 2018, time=2018-08-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1325930, encodeId=db8d13259300d, content=<a href='/topic/show?id=96c71804b7' target=_blank style='color:#2F92EE;'>#ACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=16, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1804, encryptionId=96c71804b7, topicName=ACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1e452500029, createdName=12498568m50暂无昵称, createdTime=Mon Aug 13 07:56:00 CST 2018, time=2018-08-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1026127, encodeId=51df102612ecf, content=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!, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=健健, createdTime=Sat Aug 11 19:56:00 CST 2018, time=2018-08-11, status=1, ipAttribution=)]
  9. 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encodeId=0d58189308e75, content=<a href='/topic/show?id=c738e93521f' target=_blank style='color:#2F92EE;'>#缺血性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79352, encryptionId=c738e93521f, topicName=缺血性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=66ec123, createdName=guihongzh, createdTime=Sun Apr 28 08:56:00 CST 2019, time=2019-04-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=338369, encodeId=b47c3383691b, content=学习了受益匪浅, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLDicHg2ldsSNmib46PmdzpO7CQEmPjuULp1v45zPWwMYhrnXgvl3OtmUCZSQfgITWn96X9moL94nUGA/0, createdBy=28072041016, createdName=131****1460, createdTime=Mon Aug 13 19:08:51 CST 2018, time=2018-08-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1325930, encodeId=db8d13259300d, content=<a href='/topic/show?id=96c71804b7' target=_blank style='color:#2F92EE;'>#ACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=16, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1804, encryptionId=96c71804b7, topicName=ACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1e452500029, createdName=12498568m50暂无昵称, createdTime=Mon Aug 13 07:56:00 CST 2018, time=2018-08-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1026127, encodeId=51df102612ecf, content=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!, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=健健, createdTime=Sat Aug 11 19:56:00 CST 2018, time=2018-08-11, status=1, ipAttribution=)]
    2018-08-11 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