对于心房的导管切除前和后的阿皮克萨班血度
Rachel Aakerøy1,2, Jan Pål Loennechen3,4, Roar Dyrkorn2
1Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.
PloS one
|July 31, 2024
概括
这项研究发现,患者的年龄,性别,功能和其他药物等因素显著影响房动患者接受导管切除的阿皮克萨班水平. 艾皮克萨班度的个体间变化很大,这表明可能需要对治疗药物进行监测.
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.
- 临床药房 临床药房
背景情况:
- 对心房的导管切除增加了血栓栓塞的风险,需要适当的抗凝治疗.
- 阿皮克萨班是常用的,但常规血度监测不是标准实践.
- 了解影响阿皮克萨班水平的因素对于优化抗凝治疗至关重要.
研究的目的:
- 评估患者的特征,药物相互作用和坚持如何影响阿皮克萨班度.
- 为了确定在接受导管切除的患者中阿皮克萨班水平的个体内和个体间的变化.
主要方法:
- 在导管切除之前和之后,测量了141名患者的阿皮克萨班血度.
- 利用超高性能液体染色学-并联质谱法用于药物定量.
- 使用8项莫里斯基药物坚持度表评估自我报告的坚持.
主要成果:
- 阿皮克萨班度与年龄较大,女性性别,功能下降以及较高的CHA2DS2-VASc分数正相关.
- 同时使用CYP3A4/P-gp抑制剂和阿米奥达龙增加了阿皮克萨班水平.
- 平均个体内变异率为29%,而个体间变异率为49%.
结论:
- 患者因素 (年龄,性别,功能),药物相互作用和脑血管风险影响阿皮克萨班度.
- 虽然坚持性很高,但观察到阿皮克萨班水平的实质性个体间变化.
- 治疗药物监测可能有利于更个性化的阿皮克萨班剂量策略.
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