直接口服抗凝剂和阿托瓦斯塔丁/西姆瓦斯塔丁之间的潜在相互作用:一个队列和案例交叉研究
Angel Ys Wong1, Charlotte Warren-Gash2, Krishnan Bhaskaran2
1Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London Angel.Wong@lshtm.ac.uk.
概括
与阿托瓦斯塔丁或西姆瓦斯塔丁同时使用的直接口服抗凝剂 (DOAC) 没有显示药物相互作用. 然而,与这些他类药物一起开始DOAC增加了由于患者脆弱性而导致出血和死亡的风险.
科学领域:
- 药理学 药理学是指药理学的学科.
- 心血管医学 心血管医学
- 药物相互作用 药物相互作用
背景情况:
- 直接口服抗凝剂 (DOAC) 经常与他类药物一起使用.
- DOACs与阿托瓦斯塔丁/西姆瓦斯塔丁之间的潜在药物相互作用需要澄清.
研究的目的:
- 调查阿托瓦斯塔丁/西姆瓦斯塔丁与DOAC联合处方与出血,心血管疾病和死亡风险之间的关联.
- 评估潜在的药物相互作用及其临床影响.
主要方法:
- 利用英语通用实践 (2011-2019) 数据的队列和案例交叉研究设计.
- 用阿托瓦斯塔丁/西姆瓦斯塔丁的DOAC治疗患者与使用非相互作用的他类药物的DOAC治疗患者之间的结局 (出血,心血管事件,死亡率) 的比较.
- 采用案例交叉分析来评估药物开始时的暴露模式.
主要成果:
- 队列分析显示,阿托瓦斯塔丁/西姆瓦斯塔丁的DOAC与其他他类药物的DOAC之间在出血,心血管事件或死亡率上没有显著差异.
- 病例交叉分析表明,与DOAC单独治疗相比,当与阿托瓦斯塔丁或西姆瓦斯塔丁同时开始DOAC时,出血和死亡的几率显着更高.
- 具体发现包括在开始DOACs的危险窗口中增加出血和死亡率的几率比率,而在阿托瓦斯塔丁/西姆瓦斯塔丁.
结论:
- 该研究没有发现DOACs和阿托瓦斯塔丁/西姆瓦斯塔丁之间的直接药理相互作用的证据.
- 已经服用阿托瓦斯塔丁或西姆瓦斯塔丁的患者开始服用DOAC与出血和死亡风险增加有关,这可能归因于患者在开始时的临床脆弱性.
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