艾皮克萨班与抗脂综合征患者的维生素K对抗剂:一个队列研究
Martyna Sikorska1,2, Jakub Chmiel1,2, Elzbieta Papuga-Szela2
1Department of Cardiac and Vascular Diseases, Jagiellonian University Medical College, Krakow, Poland.
Journal of cardiovascular pharmacology
|June 26, 2024
概括
像阿皮克萨班这样的直接口服抗凝剂在预防抗脂综合征 (APS) 患者的血栓方面表现出与华法林相似的有效性和安全性. 这项实践研究表明,阿皮克萨班可能是APS管理的可行选择.
科学领域:
- 心脏病学 心脏病学
- 血液学 血液学 血液学
- 类风湿病学 类风湿病学
背景情况:
- 目前的指导方针建议不要使用直接口服抗凝剂 (DOAC) 来预防反复发生的抗脂综合征 (APS) 血栓形成.
- 有限的证据支持这一建议,特别是关于阿皮克萨班和非三重阳性APS病例.
研究的目的:
- 为了评估与维生素K对抗剂 (VKA) 相比,用阿皮克萨班治疗的APS患者的血栓栓塞和出血的真实风险.
主要方法:
- 进行了一项对152名APS患者的队列研究 (66名服用阿皮克萨班,86名服用华法林).
- 随访时间平均为53个月,记录了静脉血栓栓塞,缺血性中风,心肌梗塞和重大出血事件.
主要成果:
- 阿皮克萨班组:4例血栓事件 (6.1%);VKA组:12例事件 (14%).
- 与VKAs相比,阿皮克萨班显示出类似的复发性血栓栓塞的风险 (HR=0.327) 和严重出血 (HR=0.54).
- 立方体使用与较少的事件有关,而三重阳性APS和更高的基线D-二次数预测了更多事件.
结论:
- 在现实世界APS患者中,阿皮克萨班在预防血栓栓塞和出血方面与VKAs相似.
- 这些发现表明,阿皮克萨班可能是选择APS患者的潜在治疗选择.
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