在脆弱的老年患者中使用DOAC,考虑到类泛化
Giovanni Luca Botto1, Piera Capranzano2, Paolo Colonna3
1Cardiology and Electrophysiology, Department of Medicine, ASST Rhodense, Rho & Garbagnate Hospitals, Italy.
International journal of cardiology
|June 16, 2024
概括
通用直接口服抗凝剂 (DOACs) 为心房患者 (AF) 提供治疗选择,特别是老年人和脆弱的人. 然而,关于特定患者群体和仿制药使用的临床不确定性仍然存在,强调临床医生的责任.
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.
- 老年病的医生 老年病的医生
背景情况:
- 虚弱和并发症在临床实践中显著影响治疗决策.
- 直接口服抗凝剂 (DOAC) 的泛化需要对它们的药理和生物可用性差异进行审查,特别是在老年人和脆弱的人群中.
- 在脆弱人群中,心房的管理需要仔细考虑抗凝策略.
研究的目的:
- 建立一个关于在老年和脆弱患者中使用DOACs治疗AF的全国Delphi共识.
- 解决DOAC泛化对临床实践的影响.
- 在特定的脆弱情景中提供对治疗选择的指导.
主要方法:
- 一个来自意大利的德尔菲共识过程,涉及56名心脏病专家,2名内科医生和2名神经病专家.
- 陈述使用5分利克特尺度进行评估.
- 共识被定义为>66%的同意或不同意.
主要成果:
- 在老年/虚弱患者中DOAC的疗效和安全性,虚弱患者的治疗选择以及DOAC的泛化方面达成了共识.
- 在使用10年后,DOAC分子在有效性和安全性方面的特定区分因素已确定.
- 对于某些特定情况,如慢性脏病或癌症患者,仍然存在不确定性.
结论:
- 虽然建立了DOAC,但知识缺口和不确定性仍然存在,特别是关于通用配方和特定患者子组的知识缺口和不确定性.
- 由于缺乏临床经验和知识,临床医生对通用DOAC表现出犹.
- 关于选择通用DOACs的最终决定取决于临床医生.
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