Europace:口服抗凝治疗对心房颤动患者虚弱症状与临床结局的影响分析

2022-03-11 "心关注”公众号 "心关注”公众号

据日前发表在Europace杂志上的一项研究显示,虚弱症状常见于心房颤动(AF)患者,口服抗凝剂(OAC)与所有虚弱程度的主要终点发生率降低相关。

据日前发表在Europace杂志上的一项研究显示,虚弱症状常见于心房颤动(AF)患者,口服抗凝剂(OAC)与所有虚弱程度的主要终点发生率降低相关

AF患者经常出现身体虚弱的症状,这增加了死亡和卒中的风险。为明确OAC与虚弱症患者预后之间的关联,以及AF患者是否从OAC治疗中获得净收益,Chris Wilkinson等人开展了一项回顾性队列研究,使用英国临床实践研究数据库(CPRD)1998年1月1日至2018年11月30日的AF患者数据,共纳入89,996例CHA2DS2-Vasc评分≥2的成人患者。主要结果是死亡、卒中、体循环栓塞和大出血的复合结果;次要结果是卒中、大出血、全因死亡、短暂性脑缺血发作和跌倒的复合结果

分析结果显示,在89,996例参与者中,71,256例(79.2%)有身体虚弱表现。OAC处方随虚弱程度的增加而增加;对于未开具OAC处方的患者,主要结果的发生率随虚弱程度的增加而增加。OAC处方与每个虚弱类别主要结果的减少相关(aHR,95%CI;维生素K拮抗剂[VKA] 0.69[0.64-0.75],直接口服抗凝剂[DOAC] 0.42[0.33-0.53];轻度虚弱:VKA 0.52[0.50-0.54],DOAC 0.57[0.52-0.63];中度虚弱:VKA 0.54[0.52-0.56],DOAC 0.57(0.52-0.63);严重虚弱VKA 0.48[0.45-0.51],DOAC 0.58[0.52-0.65]);DOAC的累积发病函数效应大于VKA。

原始出处:

Wilkinson C, Wu J, Clegg A, et al. Impact of oral anticoagulation on the association between frailty and clinical outcomes in people with atrial fibrillation: nationwide primary care records on treatment analysis. Europace. 2022 Mar 4:euac022. doi: 10.1093/europace/euac022. Epub ahead of print. PMID: 35244709.

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    2022-09-30 shanyongle
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    2022-03-13 sodoo

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