在AF中DOAC和VKA之间的痴呆风险降低:系统性审查和元分析
Anthipa Chokesuwattanaskul1,2, Narut Prasitlumkum3, Ryan Cooley4
1Division of Neurology, Department of Internal Medicine King Chulalongkorn Memorial Hospital, Thai Red Cross Society Bangkok Thailand.
Journal of arrhythmia
|October 17, 2024
概括
与维生素K对抗剂 (VKA) 相比,直接口服抗凝剂 (DOAC) 在非膜动 (AF) 患者中显示,痴呆的发病率较低. 这种益处在75岁以下的个体和血管痴呆症中尤为突出.
科学领域:
- 神经学 神经学
- 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:
- 非膜性心房动 (AF) 管理指南建议直接口服抗凝剂 (DOACs) 与维生素K对抗剂 (VKAs) 相比.
- 在AF患者预防认知障碍和痴呆症方面,DOAC与VKA的比较有效性仍然不完全理解.
研究的目的:
- 进行一项元分析,比较非膜动 (AF) 患者治疗直接口服抗凝剂 (DOACs) 与维生素K对抗剂 (VKAs) 的痴呆发病率.
- 调查不同年龄组和痴呆症亚型之间的痴呆风险降低的潜在差异.
主要方法:
- 在Ovid MEDLINE,EMBASE和Cochrane数据库中进行了系统的文献搜索.
- 包括的研究是随机对照试验,队列或病例对照研究,评估DOAC与VKA的AF患者的发病痴呆症.
- 随机效应元分析被用来合成事件痴呆及其亚型的危险比率 (HRs).
主要成果:
- 分析了12项涉及超过145万个人的队列研究.
- 与VKAs相比,DOACs观察到痴呆症发病率的统计显著降低 (HR 0.88,95% CI 0.83-0.93).与VKAs相比,DOACs观察到痴呆症发病率的统计显著降低.
- 这种保护作用在75岁以下的患者和血管痴呆症亚型患者中明显.
结论:
- 与维生素K对抗剂 (VKA) 相比,直接口服抗凝剂 (DOAC) 与非膜心房动 (AF) 患者的痴呆发病率较低.
- 在降低痴呆风险方面,DOACs的好处在75岁以下的患者和被诊断患有血管痴呆症的患者中尤为明显.
相关概念视频
Alzheimer's Disease: Treatment
166
Alzheimer's Disease (AD), a neurodegenerative disorder, is pathologically identified by amyloid plaques and neurofibrillary tangles composed of tau protein. AD pharmacotherapy aims to manage cognitive symptoms, delay disease progression, and treat behavioral symptoms. The treatment is primarily symptomatic and palliative, with no definitive disease-modifying therapy available. Cholinesterase inhibitors, including donepezil (Aricept), rivastigmine (Exelon), and galantamine (Razadyne), are...
166
Alzheimer's Disease: Overview
449
Alzheimer's Disease (AD) is a continually advancing neurodegenerative disorder, distinguished by escalating memory loss, cognitive dysfunction, and dementia. The disease unfolds in three stages: preclinical, mild cognitive impairment (MCI), and dementia. Its onset is insidious, and the progression gradual, with the cause not well explained by other disorders.
The clinical diagnosis of AD hinges on the presence of memory and other cognitive impairments. Biomarkers, such as changes in Aβ...
The clinical diagnosis of AD hinges on the presence of memory and other cognitive impairments. Biomarkers, such as changes in Aβ...
449
Anticoagulant Drugs: Vitamin K Antagonists and Direct Oral Anticoagulants
1.2K
Oral anticoagulants are vital tools in preventing and treating blood clotting disorders. This diverse class of medications can be categorized as vitamin K antagonists, exemplified by warfarin, and direct thrombin inhibitors (DTIs), such as dabigatran, as well as factor Xa inhibitors, including rivaroxaban.
Warfarin, a prominent vitamin K antagonist family member, exerts its effect by inhibiting the enzyme VKORC1 (vitamin K epoxide reductase complex 1). By hindering this enzyme, warfarin...
Warfarin, a prominent vitamin K antagonist family member, exerts its effect by inhibiting the enzyme VKORC1 (vitamin K epoxide reductase complex 1). By hindering this enzyme, warfarin...
1.2K
Atherosclerosis III: Management
2
Management of atherosclerosis involves an integrated strategy encompassing pharmacological treatment, surgical interventions, lifestyle changes, and nutrition therapy to address the multifactorial nature of the disease.Pharmacological TherapyA cornerstone of atherosclerosis management is the use of pharmacological agents. Statins, such as atorvastatin, are pivotal in inhibiting HMG-CoA reductase, an enzyme that catalyzes an initial step in cholesterol synthesis in the liver. This reduction in...
2
Atherosclerosis II: Clinical manifestations and prevention
2
Atherosclerosis is a progressive disorder that leads to the thickening and narrowing of arterial walls due to plaque buildup. This condition can cause various symptoms depending on the arteries affected:Coronary Artery Disease (CAD): This condition affects the coronary arteries and may lead to chest pain (angina), shortness of breath (dyspnea), heart attacks, and other heart disease symptoms.Cerebrovascular Disease: This affects blood flow to the brain, causing transient ischemic attacks (TIAs)...
2
Atherosclerosis IV: Nursing Management
2
Nursing management for a patient with arteriosclerosis involves a comprehensive approach focusing on lifestyle modification, disease monitoring, education, and symptomatic care. Here is an overview of effective nursing strategies:Assessment and Monitoring: Initial and ongoing assessments are crucial. Nurses must document the patient's medical history, including any hypertension, diabetes, hyperlipidemia, and other cardiovascular diseases. Assessments also cover family history and lifestyle...
2


