JAHA:遗传性血友病患者直接口服抗凝剂与静脉血栓栓塞

2020-11-24 MedSci原创 MedSci原创

近日,心血管疾病领域权威杂志JAHA上发表了一篇研究文章,在这项前瞻性队列研究中,研究人员旨在评估直接口服抗凝剂(DOACs)与肝素/维生素K拮抗剂在遗传性血友病患者中治疗静脉血栓栓塞(VTE)的疗效

近日,血管疾病领域权威杂志JAHA上发表了一篇研究文章,在这项前瞻性队列研究中,研究人员旨在评估直接口服抗凝剂(DOACs)与肝素/维生素K拮抗剂在遗传性血友病患者中治疗静脉血栓栓塞(VTE)的疗效和安全性。

接受DOAC(病例)或肝素/维生素K拮抗剂(对照组)治疗的VTE和遗传性血友病患者,这些患者经年龄、性别、种族和血栓形成症类型进行了匹配。该研究的终点是VTE复发和出血并发症;残留静脉血栓形成和血栓形成后综合征;停用抗凝剂后VTE复发。

该研究纳入了255例(年龄为52.4±17.3岁,女性占44.3%,严重血栓形成者占33.1%)和322例对照者(年龄为49.7±18.1岁,女性占50.3%,严重血友病者占35.1%)。病例中,抗凝治疗期间VTE复发的累积发生率为1.09%,经调整后的风险比(HR)为0.67(95%CI为0.16-2.77)。病例组累积出血发生率为10.2%,而HR为2.24(95%CI为1.10-4.58)。病例组中未发生大出血(对照组为3例)。残留静脉血栓形成和血栓形成后综合征之间无显著差异。停用抗凝剂后,DOACs可使2年VTE复发风险显著低于传统抗凝剂(HR为0.61 [95%CI为0.47–0.82])。

由此可见,DOACs和肝素/维生素K拮抗剂在血友病患者中治疗VTE疗效相似。尽管使用肝素/维生素K拮抗剂发生了大出血事件,但DOAC总体上增加了出血率。停用抗凝剂后,DOAC的使用可使2年VTE复发风险降低。

原始出处:

Elena Campello.et al.Direct Oral Anticoagulants in Patients With Inherited Thrombophilia and Venous Thromboembolism: A Prospective Cohort Study.J AM HEART ASSOC.2020.https://www.ahajournals.org/doi/10.1161/JAHA.120.018827

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    2021-05-05 fusion
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replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKibA62IFMeUJEmSyIe8DvYFeERuOsfrRd8iano7nENqQU1dRR3tqeQOUL3eqgYgEZRT2t2iaEsib0JEw/132, createdBy=66771693911, createdName=易水河, createdTime=Tue Nov 24 19:34:32 CST 2020, time=2020-11-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=901731, encodeId=36ab901e31e8, content=DOACs和肝素/维生素K拮抗剂在血友病患者中治疗VTE疗效相似。, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b58d5402080, createdName=咻凡, createdTime=Tue Nov 24 12:59:47 CST 2020, time=2020-11-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=901698, encodeId=dd62901698d5, content=停用抗凝剂后,DOAC的使用可使2年VTE复发风险降低。, beContent=null, objectType=article, channel=null, level=null, 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    2020-11-27 咻凡

    DOACs和肝素/维生素K拮抗剂在血友病患者中治疗VTE疗效相似。尽管使用肝素/维生素K拮抗剂发生了大出血事件,但DOAC总体上增加了出血率。停用抗凝剂后,DOAC的使用可使2年VTE复发风险降低。

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    展开1条回复
  5. 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replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKibA62IFMeUJEmSyIe8DvYFeERuOsfrRd8iano7nENqQU1dRR3tqeQOUL3eqgYgEZRT2t2iaEsib0JEw/132, createdBy=66771693911, createdName=易水河, createdTime=Tue Nov 24 19:34:32 CST 2020, time=2020-11-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=901731, encodeId=36ab901e31e8, content=DOACs和肝素/维生素K拮抗剂在血友病患者中治疗VTE疗效相似。, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b58d5402080, createdName=咻凡, createdTime=Tue Nov 24 12:59:47 CST 2020, time=2020-11-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=901698, encodeId=dd62901698d5, content=停用抗凝剂后,DOAC的使用可使2年VTE复发风险降低。, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM4gCIdSaEkahCNuUWZv4iaKmqvUKHyKnBiarBM9RStQKBeV5Lh6GYYFiamdV5KlSfbLvmAgZTLtq81XA/0, createdBy=13511650672, createdName=言西早, createdTime=Tue Nov 24 10:42:45 CST 2020, time=2020-11-24, status=1, ipAttribution=)]
    2020-11-26 zhaohui6731
  6. 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  8. 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replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKibA62IFMeUJEmSyIe8DvYFeERuOsfrRd8iano7nENqQU1dRR3tqeQOUL3eqgYgEZRT2t2iaEsib0JEw/132, createdBy=66771693911, createdName=易水河, createdTime=Tue Nov 24 19:34:32 CST 2020, time=2020-11-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=901731, encodeId=36ab901e31e8, content=DOACs和肝素/维生素K拮抗剂在血友病患者中治疗VTE疗效相似。, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b58d5402080, createdName=咻凡, createdTime=Tue Nov 24 12:59:47 CST 2020, time=2020-11-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=901698, encodeId=dd62901698d5, content=停用抗凝剂后,DOAC的使用可使2年VTE复发风险降低。, beContent=null, objectType=article, channel=null, level=null, 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    2020-11-24 易水河

    学习学习

    0

  9. 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replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKibA62IFMeUJEmSyIe8DvYFeERuOsfrRd8iano7nENqQU1dRR3tqeQOUL3eqgYgEZRT2t2iaEsib0JEw/132, createdBy=66771693911, createdName=易水河, createdTime=Tue Nov 24 19:34:32 CST 2020, time=2020-11-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=901731, encodeId=36ab901e31e8, content=DOACs和肝素/维生素K拮抗剂在血友病患者中治疗VTE疗效相似。, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b58d5402080, createdName=咻凡, createdTime=Tue Nov 24 12:59:47 CST 2020, time=2020-11-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=901698, encodeId=dd62901698d5, content=停用抗凝剂后,DOAC的使用可使2年VTE复发风险降低。, beContent=null, objectType=article, channel=null, level=null, 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    2020-11-24 咻凡

    DOACs和肝素/维生素K拮抗剂在血友病患者中治疗VTE疗效相似。

    0

  10. 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replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKibA62IFMeUJEmSyIe8DvYFeERuOsfrRd8iano7nENqQU1dRR3tqeQOUL3eqgYgEZRT2t2iaEsib0JEw/132, createdBy=66771693911, createdName=易水河, createdTime=Tue Nov 24 19:34:32 CST 2020, time=2020-11-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=901731, encodeId=36ab901e31e8, content=DOACs和肝素/维生素K拮抗剂在血友病患者中治疗VTE疗效相似。, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b58d5402080, createdName=咻凡, createdTime=Tue Nov 24 12:59:47 CST 2020, time=2020-11-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=901698, encodeId=dd62901698d5, content=停用抗凝剂后,DOAC的使用可使2年VTE复发风险降低。, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM4gCIdSaEkahCNuUWZv4iaKmqvUKHyKnBiarBM9RStQKBeV5Lh6GYYFiamdV5KlSfbLvmAgZTLtq81XA/0, createdBy=13511650672, createdName=言西早, createdTime=Tue Nov 24 10:42:45 CST 2020, time=2020-11-24, status=1, ipAttribution=)]
    2020-11-24 言西早

    停用抗凝剂后,DOAC的使用可使2年VTE复发风险降低。

    0

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