在老年人的口服抗凝药疗法
J Stuby1, M Haschke2, T Tritschler1
1Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Switzerland.
Thrombosis research
|April 18, 2024
概括
患有心房 (AF) 和静脉血栓塞栓症 (VTE) 的老年人面临更高的风险. 直接口服抗凝剂 (DOACs) 与较旧的药物相比具有前景,但对这一脆弱人群需要更多的研究.
科学领域:
- 老年病的医生 老年病的医生
- 心脏病学 心脏病学
- 药理学 药理学 是一个学科.
背景情况:
- 老年人 (≥65岁) 是大多数心房动 (AF) 和静脉血栓塞栓症 (VTE) 患者.
- 这种人口群体因年龄相关的生理变化和老年病症而面临更高的发病率,死亡率和治疗不足的风险.
- 对于老年人口服抗凝药 (OAC) 的试验数据有限,需要对当前证据进行审查.
研究的目的:
- 在老年人中审查AF/VTE的流行病学.
- 检查与年龄相关的变化和老年病情对OAC疗效和安全的影响.
- 总结OAC指导方针建议,并为这一群体提出未来的研究方向.
主要方法:
- 关于老年人AF/VTE现有文献的叙述性综述.
- 对包括直接口服抗凝剂 (DOAC) 和维生素K对抗剂 (VKA) 在内的OAC的疗效和安全性的证据分析.
- 考虑老年病症 (脆弱性,多药性,痴呆症) 和它们对OAC结果的影响.
主要成果:
- 有限的证据表明,在AF/VTE的老年人中,DOAC与VKA相比,可能具有更高的疗效和安全性.
- 特定的DOAC可能在老年人中具有不同的风险-益处概况.
- 目前OAC针对老年人的指导方针是基于子组分析和观察数据.
结论:
- 患有AF/VTE的老年人由于脆弱性增加,需要专门考虑抗凝药.
- 进一步的研究,包括务实,年龄特定的试验,对于优化OAC在这个人群中的使用至关重要.
- 研究较低剂量方案和最佳OAC持续时间对于改善老年患者的治疗结果至关重要.
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