口服抗凝药的选择和剂量在患有心房的非常老年患者
Martha Zergioti1, Melina Kyriakou1, Andreas S Papazoglou1
1Medical School, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece.
Journal of cardiovascular development and disease
|March 26, 2025
概括
对于老年心房患者,临床因素预测口服抗凝剂 (OAC) 治疗选择. 直接作用的口服抗凝剂 (DOAC) 和维生素K抗剂 (VKA) 的结局结果相似.
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.
- 老年病的医生 老年病的医生
背景情况:
- 对老年心房动 (AF) 患者的口服抗凝剂 (OAC) 选择是复杂的.
- 现实世界的数据对于了解这个人口中的OAC处方模式至关重要.
研究的目的:
- 调查影响老年AF患者OAC处方的临床因素.
- 将直接作用的口服抗凝剂 (DOAC) 和维生素K对抗剂 (VKA) 的结果进行比较.
- 在这个人群中评估全剂量与减少剂量的DOAC.
主要方法:
- 对MISOAC-AF试验的后期分析,包括75岁以上的住院AF患者.
- 使用调整的几率比率,确定了VKA和降低DOAC剂量的预测因素.
- 考克斯回归模型评估了全因死亡率,中风,出血和住院.
主要成果:
- 63.6%的人获得了DOAC,36.4%的人获得了VKA. 更高的CHA2DS2-VASc,HAS-BLED分数和抗血小板使用预测了VKA使用.
- 高血压,先前的中风和出血史有利于DOAC使用. 高龄和CKD预测降低了DOAC的剂量.
- 在DOACs和VKAs (aHR 0.79) 或全剂量与减少剂量的DOACs (aHR 0.96) 之间的所有原因死亡率没有显著差异.
结论:
- 临床概况预测老年AF患者的OAC选择.
- 在不同的OAC疗法和DOAC剂量策略中,结果是可比的.
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