1回,2回,または3回抗血栓療法を受けた大動脈細動患者における大出血率
PubMedで要約を見る
まとめ
この要約は機械生成です。特に高齢者またはCHA2DS2- VAScスコアが高い患者では,心房細動に対するトリプルセラピーは重大な出血リスクを増加させます. これらの高リスクグループでは,三重抗血栓治療を慎重に検討する必要があります.
科学分野
- 心臓病科
- 薬理学について
- 公衆衛生
背景
- 心房細動 (AF) の治療には,しばしば抗凝固剤と抗血小板剤が用いられます.
- 高リスクのAF患者の併用抗血栓療法による出血リスクに関するデータは限られている.
研究 の 目的
- 各種の抗血栓治療戦略において,高齢のAF患者 (≥50歳) の大出血率を評価する.
- モノセラピー,ダブルセラピー,トリプルセラピーに関連する出血リスクを比較する.
主な方法
- 処方箋データを用いたデンマークのAF患者による全国的なコホート研究.
- 重度の出血の発生率 (IR) と危険比率 (HR) を推定した.
- 分析は,治療方法,年齢,CHA2DS2-VAScスコア,および併発性によって分層化されました.
主要な成果
- トリプルセラピーは,単独療法または二重療法と比較して,著しく高い大出血率を示した.
- 90歳以上またはCHA2DS2- VAScスコアが > 6であったトリプルセラピーを受けた患者は,非常に高い出血率 (17. 6 - 22. 8/ 100 PYs) を示した.
- ビタミンKアンタゴニストのトリプルセラピーはHR3. 73を示し,直接の経口抗凝固剤のトリプルセラピーはVKA単独治療に対するHR2. 28を示した.
結論
- AF患者における三重抗血栓治療は,重度の出血リスクの大幅な増加と関連しています.
- 高齢患者 (> 90歳),CHA2DS2- VAScスコアが高かった患者 (> 6歳),または以前の出血歴のある患者では,トリプルセラピーの使用を慎重にする必要があります.
関連する概念動画
Amyloid fibrils are aggregates of misfolded proteins. Under most circumstances, misfolded proteins are either refolded by chaperone proteins or degraded by the proteasome. However, in the case of a mutation or a disease, these proteins can accumulate to form large clusters and often further assemble to form elongated fibers, called fibrils.
Amyloid deposits were observed as early as 1639 in the liver and the spleen. In 1854, Rudolph Virchow performed iodine staining,...
Bleeding in fresh concrete occurs when water from the mix rises to the surface. This happens because the mix's solid components fail to retain all the water as they settle, leading to separation where water collects at the top. The severity of bleeding can be measured by assessing the total settlement or by noting the decrease in height per unit height of concrete.
Bleeding can cause several issues in the concrete structure. Sometimes, the rising water gets trapped beneath large aggregate...
Fibril-associated collagens are a type of collagens present in the extracellular matrix with interrupted triple helices or FACIT (Fibril-associated collagens interrupted triple-helices). FACIT help connect and attach the collagen fibrils with each other as well as with other proteins of the extracellular matrix.
For example, the type II collagen fibrils in cartilage have covalently bound type IX fibril-associated collagens at regular intervals. Other types of fibril-associated collagens are...
The digestive system is responsible for the ingestion of food, secretion of enzymes, mixing and digesting food, absorption of the nutrients and defecation. The human digestive system consists of two major parts: the gastrointestinal tract and the accessory digestive organs.
Gastrointestinal tract:
Mouth: The mouth is the starting point of the digestive system. Its primary role is to mechanically break down food through chewing and mixing it with saliva, which contains enzymes that initiate...
Hormones, the biochemical messengers produced by endocrine glands, are pivotal in regulating bodily functions and maintaining homeostasis. Each hormone's balance is crucial; imbalances can lead to significant physiological disruptions. Major hormones include oxytocin, cortisol, epinephrine, estrogen, testosterone, thyroxine, growth hormone, insulin, and glucagon.
Oxytocin, produced in the hypothalamus and released by the pituitary gland, plays a role in social bonding, childbirth, and...

