当阿皮克萨班和里瓦罗克萨班干扰抗Xa检测时:一个队列研究
Georges El Hasbani1, Mahmoud Abdelrahman1, Mark Baker2
1Medicine St. Vincent's Medical Center.
Journal of Brown hospital medicine
|March 3, 2025
概括
像阿皮克萨班这样的直接XA因子抑制剂在过渡到未分离肝素 (UFH) 时需要仔细监测. 基线抗Xa水平对于安全的UFH启动和剂量来预防不良事件至关重要.
科学领域:
- 药理学 药理学是指药理学的学科.
- 心脏病学 心脏病学
- 临床医学 临床医学
背景情况:
- 直接的XA因子抑制剂 (例如,阿皮克萨班,里瓦罗克萨班) 提高了药物坚持.
- 在住院期间,患者可能会转换为未分离的肝素 (UFH).
- 剩余的Xa因子抑制活性可能会影响抗凝血监测,如抗Xa测定.
研究的目的:
- 评估剩余的XA因子抑制剂活性对抗凝血监测的影响.
- 评估转移到UFH的患者中血栓和出血事件的发生率.
- 确定基线抗Xa水平在治疗这些患者中的有用性.
主要方法:
- 从2020年12月到2022年6月入院患者的回顾性图表审查.
- 包括接受阿皮克萨班或里瓦罗克萨班治疗的患者转换为静脉注射UFH.
- 测量基线血抗Xa水平和评估不良事件.
主要成果:
- 包括48名患者;UFH桥梁的常见原因是NSTEMI (31%) 和手术前 (23%).
- 平均基线抗Xa水平为0.92 U/mL.
- 25%的患者经历了出血事件,2%的患者有血栓事件;57%的那些有不良事件的人有超治疗性基线抗Xa水平.
结论:
- 基线抗Xa水平对于正在服用Xa因子抑制剂过渡到UFH的患者来说很重要.
- 标准化基线抗Xa测量可以指导UFH启动时间和剂量.
- 这种做法可能有助于预防不良的血栓或出血事件,并为分析选择提供信息.
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