在胃肠道出血事件后重新开始口服抗凝剂治疗的患者:与华法林相比,直接口服抗凝剂的有效性和安全性
在PubMed上查看摘要
概括
此摘要是机器生成的。在患有心房 (AF) 和有严重胃肠道出血 (GIB) 的患者中,在康复后重新服用口服抗凝剂 (DOAC) 显示出出血和复合不良事件的风险较低.
科学领域
- 心脏病学
- 胃肠病学
- 药理学
背景情况
- 对于在患有心房 (AF) 之后的胃肠道出血 (GIB) 患者恢复直接口服抗凝剂 (DOACs) 和华法林的数据有限.
- 在AF患者显著出血事件后,需要指导以优化抗凝剂治疗.
研究的目的
- 在重症GIB患者住院后,重新开始服用DOAC与华法林的风险益处概况进行比较.
- 在高风险患者群体中评估不同抗凝剂策略的安全性和有效性.
主要方法
- 对商业医疗保险数据库 (2010-2017年) 的回顾性分析确定了因重大GIB住院的AF患者.
- 包括在出院后90天内存活并恢复口服抗凝药 (DOAC或华法林) 的患者.
- 使用稳定反向治疗权重 (IPTW) 来平衡共变量并比较结果.
主要成果
- 在恢复抗凝血治疗的4389名患者中,31. 3%服用DOAC,68. 7%服用华法林.
- 重新开始服用DOAC与严重出血住院的风险降低了24% (HR: 0.76,95% CI: 0.60- 0.96).
- DOAC还显示了净不良临床效应 (NACE) 综合结果的风险较低 (HR: 0.83,95% CI: 0.72- 0.97).
结论
- 在AF患者重复服用直接口服抗凝剂 (DOACs) 后,随后出现重大胃肠道出血 (GIB) 的风险降低.
- 与华法林相比,DOACs在该群体中显示出较有利的风险概况,对主要出血和复合不良事件.
- 这些发现支持在经历过严重GIB的AF患者中考虑使用抗凝药.
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