抗血栓药物使用与皮下血瘤风险的关联
David Gaist1, Luis Alberto García Rodríguez2, Maja Hellfritzsch3
1Department of Neurology, Odense University Hospital, Odense, Denmark2Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense.
JAMA
|March 1, 2017
概括
使用抗血栓药物,特别是与抗血小板药物相结合的维生素K抗药物,显著增加了皮下血瘤的风险. 抗血栓使用的增加与皮下血瘤发生率的增加有关,特别是在老年人中.
科学领域:
- 神经学
- 药理学
- 流行病学
背景情况:
- 皮下血瘤的发病率正在上升,与抗血栓药物使用的联系尚不清楚.
- 抗血栓药物越来越多地被处方,特别是在老年人群中.
研究的目的:
- 研究抗血栓药物使用与皮下血瘤 (SDH) 风险之间的关联.
- 分析一般人群中SDH发生率和抗血栓药物使用的趋势.
主要方法:
- 一项基于人口的病例对照研究,涉及丹麦1010名SDH患者和400,380名对照患者 (2000年至2015年).
- 对SDH发生率和抗血栓药物 (低剂量阿司匹林,克洛皮多格勒,直接口服抗凝剂,维生素K对抗剂) 的区域和国家数据的分析.
- 使用条件后勤回归模型来估计调整后的赔率比率 (OR).
主要成果:
- 抗血栓药物使用与更高的SDH风险有关:调整后的OR从低剂量阿司匹林的1. 24到VKA的3. 69不等.
- 结合VKA和抗血小板治疗的风险最高 (调整后的OR高达7. 93).
- SDH发病率从每10万人/年 (2000-2015年) 增加到19.0人/年,反映出抗血栓使用的增加 (31.0人/年增加到76.9人/年).
结论:
- 抗血栓药物使用与皮下血瘤风险的增加有关.
- 同时使用维生素K抗剂和抗血小板药物构成最高风险.
- 增加抗血栓剂的使用,特别是老年人中VKA的使用,可能会导致皮下血瘤的发病率上升.
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