在最初的缺血性中风后,电子监测的直接口服抗凝剂的坚持和缺血性或出血性事件之间的关系-A病例对照研究
Katharina Rekk1, Isabelle Arnet1, Fine Dietrich1
1Department of Pharmaceutical Sciences, Pharmaceutical Care Research Group, University of Basel, Basel, Switzerland.
PloS one
|April 25, 2024
概括
对直接口服抗凝剂 (DOAC) 的低坚持与心房动 (AF) 患者的复发性缺血性中风有关. 高坚持可能会增加出血风险,建议对接受DOAC治疗的AF患者进行量身定制的监测.
科学领域:
- 心脏病学 心脏病学
- 神经学 神经学
- 药理学 药理学是指药理学的学科.
背景情况:
- 心房动 (AF) 患者在中风后面临复发事件的高风险.
- 直接口服抗凝剂 (DOAC) 对于二次中风预防至关重要.
- 由于其半衰期短,必须严格遵守DOAC.
研究的目的:
- 为了研究DOAC坚持和AF患者中风后复发性临床事件之间的关系.
- 使用电子监控数据分析粘附模式.
主要方法:
- 用匹配的嵌套病例控制设计对MAAESTRO研究进行二次分析.
- 通过电子设备 (Time4MedTM) 监控的DOAC摄入量.
- 分析95天的服用和时间的坚持,根据年龄和药物负担进行调整.
主要成果:
- 病例和对照之间的平均坚持没有显著差异.
- 较低的95天服用坚持率 (<76%) 与复发性缺血事件相关.
- 较高的95天服用坚持率 (>96%) 与出血事件相关.
结论:
- 加强粘附的干预措施对于AF患者来说至关重要,以防止复发性缺血性中风.
- 对于在DOAC上高度坚持AF的患者,建议定期重新评估出血风险.
- 这些发现强调了AF中风幸存者的个性化DOAC管理策略的需要.
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