低剂量非维生素K拮抗剂口服抗凝药预防非瓣膜性心房颤动患者卒中的疗效
Efficacy of low-dose non-vitamin K antagonist oral anticoagulants for stroke prevention in patients with nonvalvular at-rial fibrillation
王帅兵 1李登科 1黄从新1
作者信息
- 1. 武汉大学人民医院心内科武汉大学心血管病研究所心血管病湖北省重点实验室(湖北武汉 430060)
- 折叠
摘要
目的 比较低剂量达比加群酯、利伐沙班和艾多沙班预防非瓣膜性心房颤动(NVAF)患者卒中的疗效.方法 回顾性分析2021年3月至2022年11月于武汉大学人民医院心血管内科住院的NVAF患者,根据纳入对象所选用的非维生素K拮抗剂口服抗凝药(NOAC)分为达比加群酯组、利伐沙班组和艾多沙班组.比较3组患者的一般资料、栓塞事件和出血事件发生率.结果 共入选360例,每组120例,平均随访11.1个月.三组一般资料无差异.达比加群酯组和利伐沙班组各发生6例有效性终点,艾多沙班组发生4例有效性终点,3组药物的有效性无明显差异(P＞0.05)].达比加群酯组发生16例安全性终点,其中消化道出血6例,利伐沙班组发生20例安全性终点,其中消化道出血10例,艾多沙班组发生17例安全性终点,其中消化道出血3例.三组药物的总出血发生率无显著性差异(P＞0.05],但利伐沙班组消化道出血发生率明显高于艾多沙班组[8.3％(10/120)vs 2.5％(3/120),P＜0.05].结论 低剂量NOAC预防NVAF患者卒中的有效性无明显差异,尽管其总出血风险相当,但艾多沙班相较于利伐沙班的消化道出血风险更低.
Abstract
Objective To compare the efficacy of low-dose dabigatran,rivaroxaban and edoxaban for stroke pre-vention in patients with nonvalvular atrial fibrillation(NVAF).Methods A retrospective analysis was performed on patients with NVAF who were hospitalized in the Department of Cardiology,Renmin Hospital of Wuhan Univer-sity from March 2021 to November 2022.According to the non-vitamin K antagonist oral anticoagulant(NOAC),the patients were divided into dabigatran group,rivaroxaban group and edoxaban group.The general data,incidence of embolization events and bleeding events of the three groups were compared.Results A total of 360 patients were selected,with 120 patients in each group.The average follow-up period was 11.1 months,There were 6 efficacy endpoints in dabigatran group and rivaroxaban group,and 4 efficacy endpoints in edoxaban group.There was no sig-nificant difference between the three groups(P＞0.05).There were 16 safety endpoints in the dabigatran group,in-cluding 6 gastrointestinal bleeding,20 safety endpoints in the rivaroxaban group,including 10 gastrointestinal bleed-ing,and 17 safety endpoints in the edoxaban group,including 3 gastrointestinal bleeding.Although there was no significant difference in the incidence of total bleeding among the three groups(P＞0.05),the incidence of gastroin-testinal bleeding in rivaroxaban group was significantly higher than that in edoxaban group[8.3％(10/120)vs 2.5％(3/120),P＞0.05].Conclusion The efficacy of low-dose NOAC for stroke prevention in NVAF patients is similar.Although the total bleeding risk is comparable between low-dose NOAC,edoxaban has a lower risk of gastrointestinal bleeding than rivaroxaban.[Chinese Journal of Cardiac Pacing and Electrophysiology,2024,38(3):171-174]
关键词
心血管病学/达比加群酯/利伐沙班/艾多沙班/低剂量/非瓣膜性心房颤动/有效性/安全性Key words
Cardiology/Dabigatran/Rivaroxaban/Edoxaban/Low-dose/Nonvalvular atrial fibrillation/Efficacy/Safety引用本文复制引用
基金项目
湖北省技术创新专项(重大项目)(2016ACA153)
出版年
2024
NETL
NSTL
万方数据