在心脏手术后新发性心房的抗凝剂处方模式
Kaitlyn M Krahn1, Sheri L Koshman2, Ting Wang3
1Department of Pharmacy, Alberta Health Services, Edmonton, Alberta, Canada.
The Annals of thoracic surgery
|December 11, 2023
概括
心脏手术后的术后心房动 (POAF) 是常见的. 抗凝剂的使用并没有降低中风风险,但增加了出血,这表明在处方这些药物时要谨慎.
科学领域:
- 心脏病学 心脏病学
- 心脏外科手术 心脏外科手术
- 药理学 药理学是指药理学的学科.
背景情况:
- 手术后心房动 (POAF) 是心脏手术后的常见并发症.
- POAF增加了血栓栓塞性中风的风险.
- 对POAF的最佳抗凝剂策略尚不清楚.
研究的目的:
- 研究心脏手术后POAF患者口服抗凝剂 (OAC) 的利用和结果.
- 评估OAC使用与中风,全身栓塞和出血风险之间的关联.
主要方法:
- 从2015年1月到2020年12月的行政数据库的回顾性分析.
- 包括心脏手术后新发POAF的成年患者.
- 排除患有先前心房动,机械门或最近使用抗凝剂的患者.
主要成果:
- 27.3%的POAF患者通过OAC,主要是华法林,得到了出院.
- 超过一半的患者在6个月内停止了OACs.
- 在30天,3个月或6个月后,在OAC用户和非用户之间没有观察到中风或全身栓塞率的显著差异.
- 在所有时间点上,OAC使用与更高的出血率有关.
结论:
- 一小部分POAF患者在心脏手术后接受OAC.
- 在这个队列中,OAC启动与增加出血风险有关,但没有明显减少中风事件.
- 仔细评估风险和益处在考虑POAF抗凝药时至关重要,特别是在术后期出血风险方面.
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