JAHA:利伐沙班在植入有CIED的房颤患者中的安全性和有效性研究

2017-06-16 MedSci MedSci原创

房颤的发生率和死亡率均较高。系统地接受抗凝治疗可以有效地防止房颤患者中风的发生,尽管在植入有心脏可植入电子设备(CIED)的患者中接受华法林治疗得到了很好的研究,但是在这种情况下,使用口服因子Xa抑制剂的临床数据却十分有限。

房颤的发生率和死亡率均较高。系统地接受抗凝治疗可以有效地防止房颤患者中风的发生,尽管在植入有心脏可植入电子设备(CIED)的患者中接受华法林治疗得到了很好的研究,但是在这种情况下,使用口服因子Xa抑制剂的临床数据却十分有限。

本研究利用比较每日直接口服Xa抑制剂利伐沙班和维生素K抗凝预防房颤患者卒中血栓发生的临床试验(ROCKET AF,n=14264)的数据,分析比较了随机接受利伐沙班和华法林抗凝治疗的植入或没有植入CIED的房颤患者的基线和临床预后的数据。在平均为期2.2年的随访期间,有453名患者(242名接受利伐沙班治疗,211名接受华法林治疗)接受了CIED的植入(64.2%)或修复(35.8%)。相比于没有植入CIED,接受有CIED植入的患者年龄更大,男性居多,有过心肌梗塞病史的更多,但卒中的发生风险没有显着差异。接受植入装置的大多数患者都有药物中断,没有接受序贯的抗凝治疗。在术后30天内,利伐沙班组有11名患者(4.55%)出现出血并发症,3名患者(1.26%)出现血栓栓塞,华法林组的有15名(7.13%)患者出现出血,1名(0.48%)出现血栓栓塞。

在利伐沙班和华法林治疗组,出血和血栓栓塞发生率均较低。植入CIED患者围手术期的口服Xa抑制剂治疗还有待进一步研究。

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    2017-06-28 1e10c84am36(暂无匿称)

    文章很好,值得拜读

    0

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    2017-06-18 1771ae4158m

    学习一下很不错

    0

  4. 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    2017-06-18 jiyangfei
  7. 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07:24:00 CST 2017, time=2017-06-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1520375, encodeId=2edc15203e580, content=<a href='/topic/show?id=7a736264553' target=_blank style='color:#2F92EE;'>#植入#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=62645, encryptionId=7a736264553, topicName=植入)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=832411313664, createdName=jiyangfei, createdTime=Sun Jun 18 07:24:00 CST 2017, time=2017-06-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1267476, encodeId=82f0126e476ca, content=<a href='/topic/show?id=922f21183d' target=_blank style='color:#2F92EE;'>#AHA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2118, encryptionId=922f21183d, topicName=AHA)], attachment=null, 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createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7LIiaRZTzJ3SEfiauCzTMPW7YvPPYLNJBXG9oh6Al1icq2VQQkIHWxqXehcicTS62YKJVBhxeth3wggw/0, createdBy=7ce01621306, createdName=天涯183, createdTime=Sat Jun 17 12:30:33 CST 2017, time=2017-06-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=211912, encodeId=b775211912e9, content=很好,学习了,谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM4o2XVpJ6449yqDsjibydI5HnJ8MibGxNn4HZiaZib0bdfibbwoz3KQrIyN9AGxq36ZlZRNicYlPfOOWMtwgsajY6mGNFiaPclFdowjD0/0, createdBy=97bd1338592, createdName=清风拂面, createdTime=Sat Jun 17 11:10:33 CST 2017, time=2017-06-17, status=1, ipAttribution=)]
    2017-06-18 zhaohui6731
  8. 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createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7LIiaRZTzJ3SEfiauCzTMPW7YvPPYLNJBXG9oh6Al1icq2VQQkIHWxqXehcicTS62YKJVBhxeth3wggw/0, createdBy=7ce01621306, createdName=天涯183, createdTime=Sat Jun 17 12:30:33 CST 2017, time=2017-06-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=211912, encodeId=b775211912e9, content=很好,学习了,谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM4o2XVpJ6449yqDsjibydI5HnJ8MibGxNn4HZiaZib0bdfibbwoz3KQrIyN9AGxq36ZlZRNicYlPfOOWMtwgsajY6mGNFiaPclFdowjD0/0, createdBy=97bd1338592, createdName=清风拂面, createdTime=Sat Jun 17 11:10:33 CST 2017, time=2017-06-17, status=1, ipAttribution=)]
    2017-06-17 虈亣靌

    不错的,学习了,谢谢分享!

    0

  9. 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createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7LIiaRZTzJ3SEfiauCzTMPW7YvPPYLNJBXG9oh6Al1icq2VQQkIHWxqXehcicTS62YKJVBhxeth3wggw/0, createdBy=7ce01621306, createdName=天涯183, createdTime=Sat Jun 17 12:30:33 CST 2017, time=2017-06-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=211912, encodeId=b775211912e9, content=很好,学习了,谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM4o2XVpJ6449yqDsjibydI5HnJ8MibGxNn4HZiaZib0bdfibbwoz3KQrIyN9AGxq36ZlZRNicYlPfOOWMtwgsajY6mGNFiaPclFdowjD0/0, createdBy=97bd1338592, createdName=清风拂面, createdTime=Sat Jun 17 11:10:33 CST 2017, time=2017-06-17, status=1, ipAttribution=)]
    2017-06-17 天涯183

    非常好的文章,学习了,很受益

    0

  10. 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createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Wed Jun 28 08:49:34 CST 2017, time=2017-06-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=212273, encodeId=f9a52122e3bf, content=学习一下很不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/11/23/ac01daf0962458a9eb8c0b1e2f6ce5bc.jpg, createdBy=04b81710322, createdName=1771ae4158m, createdTime=Sun Jun 18 11:18:27 CST 2017, time=2017-06-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1614368, encodeId=892116143689a, content=<a href='/topic/show?id=64f95426122' target=_blank style='color:#2F92EE;'>#房颤患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=18, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54261, encryptionId=64f95426122, topicName=房颤患者)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Sun Jun 18 07:24:00 CST 2017, time=2017-06-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1548233, encodeId=e841154823347, content=<a href='/topic/show?id=b9ac4e082b' target=_blank style='color:#2F92EE;'>#CIED#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4708, encryptionId=b9ac4e082b, topicName=CIED)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=7fcd14056058, createdName=12498f1em12(暂无昵称), createdTime=Sun Jun 18 07:24:00 CST 2017, time=2017-06-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1520375, encodeId=2edc15203e580, content=<a href='/topic/show?id=7a736264553' target=_blank style='color:#2F92EE;'>#植入#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=62645, encryptionId=7a736264553, topicName=植入)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=832411313664, createdName=jiyangfei, createdTime=Sun Jun 18 07:24:00 CST 2017, time=2017-06-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1267476, encodeId=82f0126e476ca, content=<a href='/topic/show?id=922f21183d' target=_blank style='color:#2F92EE;'>#AHA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2118, encryptionId=922f21183d, topicName=AHA)], attachment=null, 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createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7LIiaRZTzJ3SEfiauCzTMPW7YvPPYLNJBXG9oh6Al1icq2VQQkIHWxqXehcicTS62YKJVBhxeth3wggw/0, createdBy=7ce01621306, createdName=天涯183, createdTime=Sat Jun 17 12:30:33 CST 2017, time=2017-06-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=211912, encodeId=b775211912e9, content=很好,学习了,谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM4o2XVpJ6449yqDsjibydI5HnJ8MibGxNn4HZiaZib0bdfibbwoz3KQrIyN9AGxq36ZlZRNicYlPfOOWMtwgsajY6mGNFiaPclFdowjD0/0, createdBy=97bd1338592, createdName=清风拂面, createdTime=Sat Jun 17 11:10:33 CST 2017, time=2017-06-17, status=1, ipAttribution=)]
    2017-06-17 清风拂面

    很好,学习了,谢谢

    0

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