Cardiovasc Ther:新观点!性别因素是否应从CHA2DS2VASc评分中剔除

2018-03-30 吴星 环球医学

2018年2月,意大利科学家在《Cardiovasc Ther》发表了一个治疗困境:具有1个非性别相关(NGR)风险因素(CHA 2DS2VASc 1或2)的非瓣膜性房颤(NVAF)患者的华法林处方行为。

2018年2月,意大利科学家在《Cardiovasc Ther》发表了一个治疗困境:具有1个非性别相关(NGR)风险因素(CHA 2DS2VASc 1或2)的非瓣膜性房颤(NVAF)患者的华法林处方行为。

介绍:具有1个NGR风险因素的NVAF患者的抗凝问题一直处于争论之中。报告的未治疗个体的卒中风险不统一,该群体中与抗凝相关的出血率也未很好的定义。为此,研究者评估了华法林治疗的个体的卒中率和主要出血事件发生率。

材料和方法:START注册是一项观察性、多中心、动态起始队列研究,收集了启用抗凝治疗的NVAF个体数据。本研究中的研究对象从START注册中获取。使用注册入组时的CHA 2DS2VASc评分对卒中风险分层。

结果:总体来说,具有1个NGR风险因素的431例个体随访了604人-年。随访期记录了1例非致命性缺血性卒中(0.17/100人-年)。另一方面,有9例主要出血事件(1.49/100人-年),其中的4例为颅内出血(0.66/100人-年),其中1例为致命性。出血患者和未出血患者的患者特征、出血风险因素和治疗质量无差异。然而,观察到小于65岁患者具有更多出血事件的趋势。

结论:具有1个卒中NGR风险因素的接受华法林治疗的NVAF患者,其大出血和颅内出血风险增加。当使用华法林治疗这些患者时需要格外谨慎。

原始出处:

Denas G, Zoppellaro G, Padayattil Jose S, et al. Warfarin prescription in patients with nonvalvular atrial fibrillation and one non-gender-related risk factor (CHA2 DS2 VASc 1 or 2): A treatment dilemma. Cardiovasc Ther. 2018 Feb;36(1). doi: 10.1111/1755-5922.12310.

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    2019-01-15 quxin068
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    2019-03-09 huperzia
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    2018-04-01 changjiu

    谢谢分享.学习一下

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