开始治疗华法林与感染性内心炎患者的死亡率降低有关:基于人口的队列研究
Teddy Tai Loy Lee1, Sunny Ching Long Chan2, Oscar Hou In Chou3
1Department of Emergency Medicine, School of Clinical Medicine, The University of Hong Kong, Hong Kong, China; Cardiovascular Pharmacology Unit, Cardiovascular Analytics Group, PowerHealth Research Institute, Hong Kong, China.
Thrombosis research
|November 18, 2023
概括
在感染性内心炎 (IE) 诊断后14天内使用华法林,可降低50%的死亡率,但增加内出血风险. 在华法林使用者和非使用者之间,缺血性中风和胃肠道出血的风险仍然相似.
科学领域:
- 心脏病学 心脏病学
- 传染性疾病 传染性疾病
- 药理学 药理学是指药理学的学科.
背景情况:
- 由于出血风险,在传染性内心炎 (IE) 中使用华法林预防血栓栓塞是有争议的.
- 这项研究调查了IE患者早期开始服用华法林的疗效和安全性.
研究的目的:
- 评估在IE诊断后14天内使用华法林与临床结果之间的关联.
- 为了比较死亡,缺血性中风,内出血和胃肠道出血的风险.
主要方法:
- 基于人口的回顾性队列研究,包括1350名被诊断患有IE的患者.
- 1:1倾向分数匹配用于比较华法林使用者和未使用者,诊断后14天内开始使用.
- 使用考克斯和竞争性风险回归分析评估了长达90天的结果.
主要成果:
- 与非使用者 (n=675) 相比,华法林使用者 (n=675) 显示,与非使用者 (n=675) 相比,所有原因死亡的90天风险降低了50%.
- 在90天内缺血性中风或胃肠道出血的风险中没有发现显著差异.
- 在华法林使用者中,30天内内出血的累积发病率显著更高,但在90天内没有.
结论:
- 在IE患者中早期启动华法林与降低死亡率有关.
- 虽然对降低死亡率有效,但早期使用华法林需要仔细监测,因为内出血的风险增加,特别是在短期内.
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