功能变化与抗凝血心房动患者的临床结果之间的关联. 全国一项观察性队列研究
Kyung-Yeon Lee1, So-Ryoung Lee1,2, Eue-Keun Choi1,2
1Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea.
Frontiers in cardiovascular medicine
|June 21, 2024
概括
对于服用抗凝剂和边缘功能的心房患者,恶化功能增加了出血,衰竭和死亡的风险. 维持功能对于更好的结果至关重要.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 心脏病学 心脏病学
- 药理学 药理学是指药理学的学科.
背景情况:
- 在心房动 (AF) 患者服用口服抗凝剂时,功能至关重要.
- 功能影响AF患者中风和出血风险.
- 这项研究侧重于患有边缘性功能 (eGFR 45至<60毫升/分钟/1.73米2) 的AF患者.
研究的目的:
- 评估抗凝血AF患者患有边缘功能功能变化的功能.
- 评估这些功能变化对临床结果的影响.
主要方法:
- 利用韩国索赔数据库对抗凝血剂的AF患者进行了调查.
- 根据两年内功能变化对患者进行分类:维持,改善 (eGFR>60),或恶化 (eGFR <45).
- 分析结果包括缺血性中风,严重出血,末期脏病 (ESRD),全因死亡和复合结果.
主要成果:
- 包括5126名患者,42.3%的功能维持,44.4%的功能改善,13.1%的功能恶化.
- 恶化的群体是年龄较大,具有更多的并发症.
- 恶化的功能与较高的重大出血风险 (aHR 1.46),ESRD (aHR 1.49),全因死亡 (aHR 9.29) 和复合结局 (aHR 1.57) 有关.
结论:
- 在接受抗凝血治疗的患有边缘性功能的显著部分AF患者在两年内经历了低于eGFR 45毫升/分钟/1.73米2的衰退.
- 功能下降与严重出血,ESRD和全因死亡率的风险增加有关.
- 维持功能对于改善这种患者群体的临床结果至关重要.
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