艾皮克萨班与阿司匹林用于降低隐形性中风和心房病变后的认知衰退:ARCADIA认知研究
Ronald M Lazar1, George Howard2, Michael T Brewer1
1UAB McKnight Institute, Department of Neurology, UAB Heersink School of Medicine University of Alabama at Birmingham Birmingham AL USA.
Journal of the American Heart Association
|August 23, 2025
概括
与阿司匹林相比,在密码性中风后患有心脏病的患者中,阿皮克萨班的认知能力下降并不慢. 需要进一步的研究来找到最佳的治疗方法.
科学领域:
- 神经学
- 心脏病学
- 药理学
背景情况:
- 在ARCADIA研究中,针对心房心脏病患者的二次中风预防,研究了阿皮克萨班与阿司匹林的对比.
- 这项研究因无效而提前终止.
- 这项ARCADIA-认知研究旨在评估这些治疗对认知衰退的影响.
研究的目的:
- 在密码性中风后的患者中比较阿皮克萨班和阿司匹林的认知衰退轨迹.
- 评估阿皮克萨班会导致由于微栓塞减少而导致认知衰退的假设.
主要方法:
- 通过通过电话进行的标准化测试来评估认知功能.
- 来自五项认知测试的复合Z分数被用来衡量认知表现.
- 用混合效应模型来比较阿皮克萨班和阿司匹林组之间的认知轨迹.
主要成果:
- 总共有249名患者被纳入初级分析 (128名患者接受阿皮克萨班治疗,121名患者接受阿司匹林治疗).
- 在阿皮克萨班 (0. 107) 和阿司匹林 (0. 084) 组之间,综合认知Z分数的年变化没有显著差异 (P=0. 62).
- 在两组治疗中,认知轨迹没有显著差异.
结论:
- 在密码性中风后,阿皮克萨班和阿司匹林对心脏病患者的认知轨迹没有产生差异.
- 未来的研究应该探索心脏病特征和并发病态,以优化这种患者群体的认知衰退治疗方法.
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