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在心房患者中口服抗凝疗与中级中风风险:一个系统性审查和元分析

Zhenglei Yu¹, Xi Chen¹, Wengen Zhu²

¹Department of Cardiology, Sanming First Affiliated Hospital of Fujian Medical University, SanMing, China.

Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis

|September 26, 2025

概括

对于中等中风风险的心房患者来说,口服抗凝剂 (OAC) 并没有减少血栓栓塞事件. 然而,与没有OAC治疗相比,OAC使用与增加出血风险有关.

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.
公共卫生公共卫生

背景情况:

目前的指导方针建议对中等中风风险的AF患者提供抗凝药,但证据有限.
CHA2DS2-VASc评分有助于对AF患者中风风险进行分层.
这项研究侧重于AF患者的CHA2DS2-VASc得分为1 (男性) 或2 (女性).

研究的目的:

评估口服抗凝剂 (OAC) 治疗的有效性和安全性.
为了在中等中风风险的AF患者中比较OAC治疗与没有OAC.

主要方法:

对相关研究进行系统审查和元分析.
在PubMed和Embase数据库中进行文献搜索.
随机效应模型用于调整危险比率 (HR) 和95%置信区间 (CI) 的聚合分析.

主要成果:

使用OAC与严重出血 (HR=1.29,95%CI:1.06-1.57) 和胃肠道出血 (HR=1.38,95%CI:1.04-1.82) 的风险增加有关.
在中风或全身栓塞 (SSE) 中没有发现显著差异 (HR=0.84,95%CI:0.66-1.08).
在缺血性中风或内出血方面没有观察到显著差异.

结论:

在中等中风风险的AF患者中,OAC治疗没有显示出血栓栓塞事件的减少.
在这种患者群体中,OAC使用可能会增加出血并发症的风险,与不接受治疗相比.
需要进一步的研究来澄清OAC在中等风险AF患者中的作用.

关键词:

在CHA2DS2-VASc中使用.这是一种抗凝血药物.心房动是心房动的一种.中间风险是中间风险.一次性中风中风中风中风中风

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