直接口服抗凝剂:肥胖人口中复发静脉血栓栓塞和出血风险的概率
Courtney S Pilkerton1, Megan Adelman2, Emily Crocetti3
1Department of Family Medicine, West Virginia University, Morgantown, WV, USA.
The Annals of pharmacotherapy
|November 23, 2023
概括
直接作用的口服抗凝剂 (DOAC) 是安全有效的管理静脉血栓塞栓症 (VTE) 在肥胖患者. 这项研究发现,与华法林相比,在这个人群中使用DOACs时,不增加复发性VTE或出血事件的风险.
科学领域:
- 心脏病学 心脏病学
- 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:
- 直接作用的口服抗凝剂 (DOAC) 在静脉血栓塞栓症 (VTE) 管理中越来越受青.
- 与华法林相比,在肥胖患者中使用DOAC存在提供者的犹.
- 支持DOAC在肥胖症中的有效性和安全性的证据至关重要.
研究的目的:
- 为了评估在接受DOAC治疗的肥胖患者 (BMI ≥35 kg/m2) 和华法林治疗的肥胖患者中复发性VTE和出血事件的风险.
- 评估肥胖对DOAC有效性和安全性的影响.
- 为了向临床实践提供关于VTE肥胖患者抗凝药的信息.
主要方法:
- 在西弗吉尼亚州进行的一项回顾性研究,该地区的肥胖率很高.
- 对1633名VTE患者的分析,比较DOAC和华法林用户之间的结果.
- 评估与体重指数 (BMI) 和抗凝剂选择有关的复发性血栓事件,严重出血以及任何出血事件.
主要成果:
- 没有发现BMI和复发性VTE,或任何/重大出血事件之间的显著关联.
- 高龄,抗血小板使用和相互作用的药物与增加出血风险有关.
- 与DOAC相比,华法林使用与较高频率的重大出血事件有关.
结论:
- DOAC证明了肥胖患者的VTE的适当和有效管理.
- 在这个人群中,BMI不是VTE或出血事件复发的预测因素.
- 这些发现支持医疗服务提供者对对肥胖VTE患者处方DOACs的信心增加.
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