直接口服抗凝剂和华法林使用者的胃肠道出血的真实风险:使用共同数据模型进行分布式网络分析
Jae Myung Cha1, Myoungsuk Kim1, Hyeong Ho Jo2
1Department of Internal Medicine, Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University, Seoul, Korea.
直接口服抗凝剂 (DOAC) 在新使用者中显示了与华法林相比的胃肠道出血 (GIB) 风险. 与里瓦罗克萨班或达比加特兰相比,特定的DOAC如埃多克萨班或阿皮克萨班的GIB风险较低.
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.
- 胃肠病学 胃肠病学
背景情况:
- 与华法林相比,直接口服抗凝剂 (DOAC) 显示出胃肠道出血 (GIB) 风险概况的演变.
- 以前的研究报告的风险更高,但最近的证据表明风险降低.
研究的目的:
- 为了比较新的直接口服抗凝剂 (DOAC) 和华法林新用户之间的胃肠道出血 (GIB) 风险.
- 分析不同年龄组和性别的GIB风险,以及DOAC子组内的风险.
主要方法:
- 一项使用八家医院共同数据模型进行的比较研究.
- 倾向性得分匹配被用来分析3,347对新的DOAC和华法林使用者.
- 排除标准包括先前的GIB病史或同时使用两种药物类型.
主要成果:
- 在新的DOAC使用者和新的华法林使用者之间,GIB的总体风险是可比的 (HR,0.95;95% CI,0.65至1.40).
- 在DOAC和华法林使用者之间,在各年龄组 (>65,>75岁) 或性别之间没有观察到GIB风险的显著差异.
- DOAC亚组显示出不同的GIB风险,埃多克萨班或阿皮克萨班的风险比里瓦罗克萨班或达比加特兰低26% (HR,0.74;95%CI,0.69至1.00).
结论:
- 在现实临床实践中,直接口服抗凝剂 (DOAC) 对新用户来说,具有与华法林相比的胃肠道出血 (GIB) 风险.
- 在DOAC中,埃多克萨班和阿皮克萨班与Rivaroxaban和Dabigatran相比,似乎与较低的GIB风险有关.
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