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直接口服抗凝剂在心脏手术后的早期使用:一个回顾性队列研究

Jung-Jin Wu¹, Jessie Jiang², Jian Ye³

¹Department of Pharmacy, Ridge Meadows Hospital, and Faculty of Pharmaceutical Sciences, Maple Ridge, British Columbia, Canada.

|April 8, 2024

概括

直接口服抗凝剂 (DOAC) 被处方给30%的心脏手术后的患者,与华法林相比,在出血或住院没有显著差异. 这项研究提供了对该患者群体中DOAC使用的见解.

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.
临床医学临床医学

背景情况:

关于心脏手术后使用直接口服抗凝剂 (DOAC) 的文献有限.
心脏手术患者经常被排除在重大临床试验之外.
在心脏手术后需要早期的DOAC处方指南.

研究的目的:

为了比较医院内DOAC使用与心脏手术后早期的华法林.
为了确定与DOAC处方相关的因素.
为了评估术后停留时间和出血事件.

主要方法:

在心脏手术后接受抗凝血药物治疗的成年患者的回顾性队列研究.
对照患者在DOACs与华法林.
排除了具有DOAC禁忌的患者.

主要成果:

在210名患者中,30%的患者在出院后接受了DOAC;70%的患者接受了华法林.
阿皮克萨班是最常见的DOAC;中位数的开始是术后的第5天.
两组之间在术后停留时间或住院出血方面没有显著差异.

结论:

直接口服抗凝剂 (DOAC) 在心脏手术后约三分之一的患者中使用.
使用DOAC与老年,较少的膜疾病,手术前使用DOAC和孤立的CABG有关.
在DOAC和华法林组之间,出血和停留时间没有差异.

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