在极度体重患者中使用DOAC:来自未来START注册表的结果
Matteo Guarascio1, Lorenza Bertù2, Marco Paolo Donadini2,3
1Vito Fazzi Hospital, U.O. Medicina Interna, Lecce, Italy. guarasciomatteo@gmail.com.
Internal and emergency medicine
|June 10, 2023
概括
直接口服抗凝剂 (DOAC) 和维生素K对抗剂 (VKA) 在极度体重的患者中显示出类似的安全性和有效性. 这项研究评估了低体重和肥胖患者的DOAC和VKA的静脉血栓栓塞和心房动.
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.
- 临床医学 临床医学
背景情况:
- 直接口服抗凝剂 (DOAC) 是预防静脉血栓塞栓症 (VTE) 和心房动 (AF) 的标准.
- 关于低体重 (≤50公斤) 和肥胖 (≥120公斤) 患者的DOAC和维生素K抗体 (VKA) 的数据有限.
- 在START-Register研究中,研究了极端体重人群中抗凝剂的使用情况.
研究的目的:
- 评估DOAC与VKA相比的安全性和有效性,用于极端体重的患者.
- 在接受抗凝药的体重不足和肥胖患者中评估血栓事件率和重大出血 (MB).
主要方法:
- 一项观察性前性队列研究 (START-Register) 包括10,080名接受抗凝药治疗的成年患者.
- 患者按体重分类:≤50公斤 (体重不足) 和≥120公斤 (肥胖).
- 随访时间中位数为1.5年,评估了静脉瘤复发,中风,全身栓塞和严重出血.
主要成果:
- 血栓事件发生率很低,在体重不足和肥胖群体中,DOAC和VKA之间是相似的.
- 在重量级别的DOAC和VKA之间,重大出血事件也相似.
- 队列中的肥胖患者比体重不足患者年轻得多.
结论:
- 直接口服抗凝剂 (DOAC) 似乎对极度体重 (体重不足和肥胖) 的患者有效和安全.
- 研究结果表明,对于这些患者群体,可以考虑DOAC.
- 建议进行进一步的前性研究来证实这些结果.
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