在患有非膜性心房动的患者中,抗凝剂的充足性
M Fernández-Pérez1, Á Pereda1, M Gabilondo1
1Basque Health Service (Osakidetza), Araba University Hospital, Department of Haematology, Jose Atxotegi Kalea, s/n, Vitoria-Gasteiz, 01009, Spain.
Journal of healthcare quality research
|February 14, 2026
概括
在临床实践中,对于非膜性心房动 (NVAF) 的抗凝治疗往往是不充分的. 提高对指导方针的遵守度至关重要,因为许多患者接受了低于最佳的治疗,从而增加了中风风险.
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:
- 与临床试验相比,在常规实践中,非膜动 (NVAF) 中抗血栓治疗的益处在减少,主要是由于处方问题.
- 在新诊断的NVAF患者中评估抗凝血剂在现实世界中的充分性对于改善患者的治疗结果至关重要.
研究的目的:
- 评估在临床环境中新诊断患有非膜性心房动 (NVAF) 的患者的抗凝治疗的充分性.
- 确定导致NVAF患者抗凝治疗不足的因素.
主要方法:
- 一项回顾性观察性研究分析了1446名NVAF患者的治疗充分性.
- 直接作用的口服抗凝剂 (DOAC) 和维生素K抗剂 (VKA) 疗法的充分性根据产品指南和治疗范围进行了评估.
- 后勤回归分析确定了抗凝不充分的预测因素.
主要成果:
- 只有75%的DOAC和33%的VKA治疗被认为是充足的.
- 剂量不足是DOAC (25%) 和VKA (67%) 的首要问题.
- 很大一部分未接受治疗的患者 (43%) 缺乏不接受抗凝药的临床理由.
结论:
- 在临床实践中,对于NVAF患者的抗凝剂充足度存在很大变化.
- 目前治疗的充分性还不足以达到指导方针的建议,近一半的患者没有得到足够的抗凝剂.
- 严格遵守临床指导方针是必要的,以提高抗凝药的有效性和降低NVAF中风风险.
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