最佳的直接口服抗凝剂用于上部胃肠道内镜下粘膜剖析
Yoshitaka Ono1, Waku Hatta2, Kunio Tarasawa3
1Division of Gastroenterology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-Machi, Aoba-Ku, Sendai, 980-8574, Japan.
里瓦罗克萨班可能是最好的直接口服抗凝剂 (DOAC) 用于上部胃肠道内镜下粘膜解剖 (ESD). 与其他DOAC相比,它显示出缺血性中风和延迟出血的风险较低.
科学领域:
- 胃肠病学 胃肠病学
- 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:
- 接受直接口服抗凝剂 (DOACs) 的患者在上部胃肠道内镜下粘膜解剖 (ESD) 后面临缺血性中风和出血的高风险.
- 确定最佳的DOAC对于管理这些不良事件至关重要.
研究的目的:
- 为了确定最适合的DOAC患者接受上部胃肠道ESD.
- 为了比较不同DOAC之间缺血性中风和延迟出血的风险.
主要方法:
- 一项回顾性队列研究分析了2012年至2021年期间在日本接受上胃肠道ESD的9729名患者.
- 反向概率权衡平衡的DOAC组 (达比加特兰,里瓦罗克萨班,阿皮克萨班,埃多克萨班).
- 后勤回归比较了缺血性中风和延迟出血的风险.
主要成果:
- 与达比加特兰相比,里瓦罗克萨班和阿皮克萨班的缺血性中风风险显著降低.
- 达比加特兰在胃肠ESD中显示出延迟出血的风险最低,其次是里瓦罗克萨班.
- 在食道ESD中观察到延迟出血的类似趋势,尽管在统计学上不显著.
结论:
- 里瓦罗克萨班似乎是上部胃肠道ESD的最佳DOAC选择.
- 它在这个患者群体中提供了缺血性中风和延迟出血的降低风险概况.
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