Medicine:新型口服抗凝剂(NOAC)改善非血管性房颤患者的抗栓治疗

2015-09-26 phylis 译 MedSci原创

指南推荐缺血性卒中的房颤患者应用口服抗凝剂(0AC)。但是,世界范围内华法林的应用处于处方不足或剂量不足的状态。研究人员旨在探索对非血管性房颤(NVAF)的缺血性卒中患者进行抗血栓治疗时,应用新型抗凝剂(NOAC)是否有效。2011年1月到2013年12期间,招募了360名NVAF的急性缺血性卒中患者。根据NOAC应用的日期(2012年7月)将病人分为两组。在2012年7月之前共招募184名患者,

指南推荐缺血性卒中的房颤患者应使用口服抗凝剂(0AC)。但是,世界范围内华法林的应用处于处方不足或剂量不足的状态。研究人员旨在探索对非血管性房颤(NVAF)的缺血性卒中患者进行抗栓治疗时,应用新型抗凝剂(NOAC)是否有效。

2011年1月到2013年12期间,招募了360名NVAF的急性缺血性卒中患者。根据NOAC应用的日期(2012年7月)将病人分为两组。在2012年7月之前共招募184名患者,2012年7月之后招募176名患者。比较人口学统计数据,相关因素以及应用OAC的比例。出院一个月后,OAC的利用率(29% VS 41%)以及抗凝剂有效率(22.2% VS 80.6%)显著升高。NOAC有效后,华法林应用率下降(28.3% VS 11%)。两组抗血小板药物的应用升高(57% VS 52%)。影响OAC应用的因素是年龄(OR=0.947;95%CI: 0.912 0.984),BI(OR=1.012; 95%CI:1.000 1.025),以及NOAC有效性(OR=1.857; 95%CI:1.086 3.175)。随访一个月后,大部分NVAF缺血性卒中患者的应用NOAC药物比应用华法林治疗的患者效果好。

应用NOAC有效后,应用抗栓药物治疗得到改善。但是,大部分患者仍然接受抗血小板药物进行血栓性卒中的干预。

原文出处:

Lin YP, Tan TY. Do NOACs Improve Antith otic Therapy in Secondary Stroke Prevention in Nonvalvular Atrial Fibrillation? Medicine (Baltimore). 2015 Sep.


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    2016-08-08 jeanqiuqiu
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    2016-08-10 kalseyzl
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    2015-09-28 30397607
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