慢性冠状动脉疾病患者口服抗凝剂单疗法:更新的元分析
Mushood Ahmed1, Jamal S Rana2, Raheel Ahmed3
1Rawalpindi Medical University, Rawalpindi, Pakistan.
The American journal of medicine
|September 27, 2025
概括
对于长期服用抗凝药的慢性冠心病患者,口服抗凝剂 (OAC) 单疗比双疗更安全. 这种方法可以减少出血事件而不会增加缺血风险,支持更简单的抗血栓策略.
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.
- 临床试验 临床试验
背景情况:
- 对于需要长期抗凝药的慢性冠状动脉疾病 (CCD) 患者,最佳的抗凝药策略尚不清楚.
- 双重治疗 (口服抗凝剂 (OAC) +抗血小板剂) 会增加出血风险.
- 这一元分析比较了OAC单一治疗与联合治疗的疗效和安全性.
研究的目的:
- 在需要长期抗凝药的CCD患者中,比较OAC单疗与双疗的疗效和安全性.
- 评估对主要不良心血管事件和出血的影响.
主要方法:
- 通过2025年8月对PubMed,Embase,ClinicalTrials.gov和Cochrane图书馆进行系统搜索.
- 包括5个随机对照试验 (RCT) 与4964名参与者.
- 主要结局:心血管死亡,中风,心肌梗塞和严重出血的组合.
主要成果:
- 单独治疗OAC显著降低了初级复合结局风险 (RR:0.68).
- 在所有原因的死亡,心血管死亡,心脏病发作,中风或全身栓塞中没有显著差异.
- OAC单疗可显著降低重大出血 (RR:0.49) 和临床相关的非重大出血 (RR:0.51).
结论:
- 在长期服用抗凝药的CCD患者中,OAC单一疗法有效降低出血并发症.
- 与双重治疗相比,它不会增加缺血事件的风险.
- 支持一个简化的抗血栓策略,没有抗血小板药物为这一群体.
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