用维生素K对抗剂治疗症状性静脉血栓栓塞的长期和短期治疗
Saskia Middeldorp1, Barbara A Hutten2
1Department of Vascular Medicine, University of Amsterdam, Academic Medical Center, Amsterdam, the Netherlands.
JAMA
|July 8, 2015
概括
与短期VKA治疗相比,对静脉血栓塞栓症 (VTE) 的长期维生素K抗体 (VKA) 治疗可以减少复发的VTE,但会增加大出血风险. 在两个持续时间之间,死亡风险保持不变.
科学领域:
- 心血管医学 心血管医学
- 血液学 血液学 血液学
- 药理学 药理学是指药理学的学科.
背景情况:
- 静脉血栓塞栓症 (VTE) 是发病率和死亡率的一个重要原因.
- 维生素K抗剂 (VKA) 是用于静脉瘤治疗的标准抗凝剂.
- 维卡治疗的最佳持续时间仍然是一个临床问题.
研究的目的:
- 在症状性VTE患者中,比较长期 (≥3个月) 和短期VKA治疗之间的复发性VTE,严重出血和死亡率.
主要方法:
- 这项研究分析了与VKAs治疗的有症状的VTE患者的结果.
- 比较侧重于长期 (≥3个月) 与短期VKA治疗持续时间.
主要成果:
- 与短期治疗相比,长期的VKA治疗与复发性VTE的风险降低有关.
- 在长期的VKA治疗中观察到较大的出血风险增加.
- 长期和短期VKA治疗组之间没有发现死亡率的显著差异.
结论:
- 长期的VKA治疗有效地减少了复发性VTE,但增加了严重出血的风险.
- 当出血风险是一个主要问题时,可以考虑短期的VKA治疗.
- 对VTE的治疗持续时间的决定应该平衡有效性和安全性.
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