静脈血栓塞栓症のアウトカムにおける性差: GARFIELD- VTE レジストリからの発見
Paolo Prandoni1, Meg Fluharty2, Sebastian Schellong3
1Arianna Foundation on Anticoagulation, Bologna, Italy.
European journal of internal medicine
|August 26, 2025
まとめ
静脈血栓塞栓症 (VTE) の女性では,男性に比べて出血のリスクが高く,VTEの再発,心臓発作,脳卒中のリスクは低い. 性別がVTE患者の抗凝固剤治療の結果に影響する.
科学分野:
- 心血管医学
- 血液学
- 臨床流行病学
背景:
- 静脈血栓塞栓症 (VTE) の患者における臨床結果に対する性別の影響については,さらなる明確化が必要である.
- 性別による違いを理解することは パーソナライズされたVTE管理に不可欠です
研究 の 目的:
- VTE患者の臨床結果と抗凝固治療の有効性を性別の差異で分析する.
- VTEの管理における異なる抗凝固薬 (親腸内投与,VKA,DOAC) との性との相互作用を調査する.
主な方法:
- GARFIELD- VTEのレジスタリから得られたデータを分析し,3年間の追跡期間で10,650人の患者を対象とした.
- 評価されたアウトカム:全因死亡率,VTE再発,大/任意の出血,心筋梗塞/急性冠動脈症候群,脳卒中/一時的な性発作.
- 抗凝固剤療法との性相互作用を評価するために,コックス比例リスクモデルを使用した.
主要な成果:
- 女性 (49. 7%) は男性に比べて大きな出血や出血のリスクを高めた.
- 女性では,静脈動脈梗塞の再発,心筋梗塞/急性冠動脈症候群,脳卒中/短期間性不全症候群のリスクが低かった.
- ビタミンKアンタゴニスト (VKA) と直接経口抗凝固剤 (DOAC) の使用者間で,出血リスクの性別の違いが観察されました.
結論:
- VTEの女性では,男性と比較して出血のリスクが高く,再発性VTE,心筋梗塞/急性冠動脈症候群,脳卒中/短期間性血栓性発作のリスクは低くなっています.
- 性別は抗凝固剤治療 (VKAとDOAC) と静脈動脈炎患者の出血リスクの関係に大きく影響する.
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