在患有非膜性心房的老年患者中,不坚持口服抗凝疗
Yue Cao1, Yue-Yue Feng1, Wei Du1
1Division of Cardiology, Xuzhou Central Hospital, Xuzhou, People's Republic of China.
Patient preference and adherence
|December 12, 2023
概括
口服抗凝剂 (OAC) 的不持续性在老年心房 (AF) 患者中很高,许多人在出院后不久就停止治疗. 患者的偏好和人口因素显著影响这种行为,需要早期干预以改善坚持.
科学领域:
- 心脏病学 心脏病学
- 老年病的医生 老年病的医生
- 药理学 药理学是指药理学的学科.
背景情况:
- 心房动 (AF) 是老年人常见的疾病,增加了中风的风险.
- 口服抗凝剂 (OAC) 治疗对于AF患者中风预防至关重要.
- 对OAC治疗的不持续性是一个重大的临床挑战,特别是在老年人群中.
研究的目的:
- 调查老年AF患者OAC不持续的原因.
- 在这个人口群体中确定影响OAC治疗中止的因素.
主要方法:
- 纳入了老年AF患者 (≥75岁) 的队列.
- 收集了关于临床因素,人口统计和药物的数据.
- OAC不持续性被定义为停止治疗>30天或切换治疗;多变量Cox回归被用于确定预测因素.
主要成果:
- 在560名患者中,57.5%的患者在20个月的中位随访期间观察到药物持续性.
- 华法林的非持续性高于NOAC (48.8%与33.6%相比).
- 不持续性的主要预测因素包括永久心脏起器植入,抗血小板使用和患者偏好,其中81.8%在出院后3个月内停止使用.
结论:
- OAC不持续性仍然是老年AF患者的一个重要问题,通常在出院后很早发生.
- 人口因素和患者偏好是非持久性的主要驱动因素.
- 需要针对已识别的风险因素和患者偏好的干预措施,以改善长期OAC遵守.
相关概念视频
Anticoagulant Drugs: Vitamin K Antagonists and Direct Oral Anticoagulants
1.2K
Oral anticoagulants are vital tools in preventing and treating blood clotting disorders. This diverse class of medications can be categorized as vitamin K antagonists, exemplified by warfarin, and direct thrombin inhibitors (DTIs), such as dabigatran, as well as factor Xa inhibitors, including rivaroxaban.
Warfarin, a prominent vitamin K antagonist family member, exerts its effect by inhibiting the enzyme VKORC1 (vitamin K epoxide reductase complex 1). By hindering this enzyme, warfarin...
Warfarin, a prominent vitamin K antagonist family member, exerts its effect by inhibiting the enzyme VKORC1 (vitamin K epoxide reductase complex 1). By hindering this enzyme, warfarin...
1.2K
Anticoagulant Drugs: Low-Molecular-Weight Heparins
708
Hemostasis is a crucial process that prevents excessive blood loss from damaged blood vessels. It involves various mechanisms such as vasoconstriction, platelet adhesion and activation, and fibrin formation. The importance of each mechanism depends on the type of vessel injury. In contrast, thrombosis is the abnormal formation of a blood clot within the blood vessels, leading to potential complications if the clot obstructs blood flow. Thrombosis can be caused by increased coagulability of the...
708
Antiplatelet Drugs: Prostaglandin Synthesis, P2Y12 and Glycoprotein IIb/IIIa Inhibitors
526
Antiplatelet drugs emerge as frontline defenders against the insidious threat of thromboembolic diseases, where abnormal clots obstruct vital blood vessels. These drugs stand as bulwarks, inhibiting platelet aggregation and clot formation, thereby mitigating the risk of life-threatening conditions like myocardial infarction, coronary artery disease, and thrombotic strokes.
Prostaglandin synthesis inhibitors, exemplified by the widely known aspirin, wield their power by irreversibly acetylating...
Prostaglandin synthesis inhibitors, exemplified by the widely known aspirin, wield their power by irreversibly acetylating...
526
Heart Failure Drugs: Inhibitors of Renin-Angiotensin System
436
The activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) contributes to cardiac remodeling, and inhibiting the RAAS is a pharmacological target in heart failure management. As a result, neurohumoral modulation is a crucial treatment principle for managing heart failure. This approach involves using medications like ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRAs), and neutral...
436
Factors Affecting Drug Response: Overview
2.0K
When it comes to infants and young children, they are typically administered smaller doses of medication in comparison to adults. This is primarily because their organ functions still need to fully develop, meaning their bodies are not as efficient at metabolizing or eliminating drugs. Additionally, their blood-brain barrier is more permeable than in adults. As a result, high concentrations of drugs can easily penetrate the central nervous system (CNS), potentially leading to neurological...
2.0K


