JAHA:服用非维生素K拮抗剂口服抗凝剂的房颤患者患痴呆症风险更低

2021-02-16 MedSci原创 MedSci原创

相比于使用华法林治疗的患者,使用NOAC治疗的AF患者发生痴呆的风险较低。但需要进一步的随机临床试验来证明这些结果。

房颤(AF)患者患痴呆症的风险更高。当AF患者使用不同的抗凝剂时,患痴呆风险的结果并不一致。近日,血管疾病领域权威杂志JAHA上发表了一篇研究文章,研究人员旨在调查接受非维生素K拮抗剂口服抗凝剂(NOACs)与华法林的AF患者发生痴呆的风险。

研究人员使用台湾健康保险研究数据库进行了全国性的人群队列研究。研究人员征集了所有AF病例,然后选择在2012年至2016年之间接受NOAC或华法林治疗至少90天的病例。首次诊断为痴呆是该研究的主要结局。研究人员进行了倾向得分匹配,以最小化每个队列之间的差异。研究人员使用Fine和Gray竞争风险回归模型来计算痴呆的风险比(HR)。

该研究共招募了12068例AF患者(每组6034例患者)。受试者使用NOAC和华法林治疗的平均随访时间分别为3.27年和3.08年。与使用华法林相比,使用NOAC治疗的患者发生痴呆的HR为0.82(95%CI为0.73-0.92;P=0.0004)。亚组分析表明,相比具有类似特征的华法林使用者,年龄在65-74岁的NOAC使用者发生卒中或出血的风险较高,而发生痴呆症的风险较低。

由此可见,相比于使用华法林治疗的患者,使用NOAC治疗的AF患者发生痴呆的风险较低。但需要进一步的随机临床试验来证明这些结果

原始出处:

Jin‐Yi Hsu.et al.Lower Risk of Dementia in Patients With Atrial Fibrillation Taking Non‐Vitamin K Antagonist Oral Anticoagulants: A Nationwide Population‐Based Cohort Study.J AM HEART ASSOC.2021.https://www.ahajournals.org/doi/full/10.1161/JAHA.120.016437

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    2021-04-07 Boyinsh
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    2021-02-18 zhaohui6731
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  5. 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time=2021-02-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1048726, encodeId=cb4a1048e2614, content=老年人痴呆何药可用??, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=junJUN, createdTime=Tue Feb 16 14:49:32 CST 2021, time=2021-02-16, status=1, ipAttribution=)]
  6. 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  8. 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time=2021-02-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1048726, encodeId=cb4a1048e2614, content=老年人痴呆何药可用??, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=junJUN, createdTime=Tue Feb 16 14:49:32 CST 2021, time=2021-02-16, status=1, ipAttribution=)]
  9. 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time=2021-02-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1048726, encodeId=cb4a1048e2614, content=老年人痴呆何药可用??, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=junJUN, createdTime=Tue Feb 16 14:49:32 CST 2021, time=2021-02-16, status=1, ipAttribution=)]
    2021-02-16 心介

    房颤,临床上碰到很多哦

    0

  10. 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time=2021-02-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1048726, encodeId=cb4a1048e2614, content=老年人痴呆何药可用??, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=junJUN, createdTime=Tue Feb 16 14:49:32 CST 2021, time=2021-02-16, status=1, ipAttribution=)]
    2021-02-16 junJUN

    老年人痴呆何药可用??

    0

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