公共卫生 公共卫生
Anna L Parks1, Jacquelyn M Lykken2, Meghan L Rieu-Werden2
1University of Utah, Salt Lake City, UT, USA.
Alzheimer's & dementia : the journal of the Alzheimer's Association
|December 23, 2025
概括
大约7-8%的轻度认知障碍或痴呆症患者每年会发展出需要抗血栓治疗的心血管疾病. 这种风险对于抗粉样蛋白治疗的共享决策至关重要.
科学领域:
- 神经学 神经学
- 心脏病学 心脏病学
- 老年病的医生 老年病的医生
背景情况:
- 抗粉胺单克隆抗体可能会增加内出血 (ICH) 的风险,当与抗凝固剂或血栓抑制剂.
- 专家指导建议不要同时使用抗血栓性药物,因为ICH风险升高.
- 在老年人中,新的心血管诊断很常见,在抗粉样蛋白治疗期间可能需要抗血栓治疗.
研究的目的:
- 估计在轻度认知障碍 (MCI) 或痴呆症患者中需要抗血栓治疗的新病的发生率.
- 为了为临床决策提供有关抗粉样类疗法和抗血栓剂的联合处方的信息.
主要方法:
- 一项纵向队列研究利用了健康和退休研究 (HRS) 的数据 (2010-2020年) 与医疗保险索赔联系.
- 包括65岁以上的成年人,没有先前的抗凝固药物指示.
- 细灰色生存模型评估了1年的心房动,深静脉血栓/肺栓塞,心肌梗塞,中风和新的抗凝剂处方的发病率,这些都占死亡的竞争风险.
主要成果:
- 这项研究分析了22,373名参与者 (平均年龄71岁).
- 在患有MCI的个体中,抗血栓治疗新征兆的1年发病率为6.9%.
- 在患有痴呆症的人群中,1年发病率为7.6%.
结论:
- 很大一部分 (7-8%) 患有MCI或痴呆症的人在一年内发展出需要抗血栓治疗的心血管疾病.
- 这种发病率凸显了在讨论抗粉样蛋白治疗时需要考虑抗血栓治疗指示的必要性.
- 将这种风险整合到共享决策中可以优化患者的护理和安全.
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