与华法林相比,达比加特兰治疗过程周边出血和血栓栓事件:长期抗凝治疗随机评估 (RE-LY) 随机试验的结果
Jeff S Healey1, John Eikelboom, James Douketis
1Population Health Research Institute, McMaster University, Hamilton, Canada. Jeff.Healey@phri.ca
Circulation
|June 16, 2012
概括
达比加特兰和华法林在接受侵入性手术,包括紧急手术的患者中显示出类似的周围手术出血率. 达比加特兰还允许更短的抗凝药中断期.
科学领域:
- 心脏病学 心脏病学
- 药理学 药理学是指药理学的学科.
- 临床试验 临床试验
背景情况:
- 华法林是一种常见的口服抗凝剂,但达比加特兰可以降低缺血性中风风险.
- 人们对达比加特兰在手术期间的出血风险存在担忧,原因是缺乏易于获得的解药.
- 该RE-LY试验提供了一个强大的数据集,用于在各种临床场景中比较这些抗凝剂.
研究的目的:
- 在接受侵入性手术的患者中,比较达比加特兰和华法林之间的周围手术出血风险.
- 评估与华法林相比,达比加特兰缺乏解药是否会影响出血率.
- 为了评估使用两种药物的手术所需的口服抗凝剂中断的持续时间.
主要方法:
- 对从RE-LY试验中接受侵袭性手术的患者进行分析.
- 从手术前7天到手术后30天评估出血率.
- 在达比加特兰 (110毫克和150毫克) 和华法林组之间比较主要的周围手术出血.
主要成果:
- 达比加特兰 (3.8%-5.1%) 和华法林 (4.6%) 组之间没有观察到重大周围手术出血率的显著差异.
- 在需要紧急手术的患者中,出血率也相似:达比加特兰 (17.8%-17.7%) 与华法林 (21.6%).
- 与华法林 (114小时) 相比,服用达比加特兰的患者的口服抗凝药中断时间 (49小时) 显著较短.
结论:
- 达比加特兰和华法林与类似的外周手术出血风险有关,即使是在紧急的手术情况下.
- 达比加特兰的使用允许在手术前减少口服抗凝药中断的持续时间.
- 这些发现支持在需要侵入性手术的患者中使用达比加特兰,平衡有效性和安全性.
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