阿皮克萨班与阿司匹林以及ARCADIA试验中的出血风险
Hooman Kamel1, W T Longstreth2,3,4, David L Tirschwell2
1Clinical and Translational Neuroscience Unit, Department of Neurology and Feil Family Brain and Mind Research Institute, Weill Cornell Medicine, New York, NY.
Annals of neurology
|February 25, 2026
概括
与阿司匹林相比,阿皮克萨班在患有密码性中风和心房心脏病的患者中显著减少了内出血. 在使用阿皮克萨班时,没有观察到其他出血事件的风险增加.
科学领域:
- 神经学 神经学
- 心脏病学 心脏病学
- 血栓形成和血液静止.
背景情况:
- 阿皮克萨班和阿司匹林之间的比较出血风险尚未得到充分证实.
- 心房心脏病变与中风风险增加有关.
研究的目的:
- 在ARCADIA试验中,比较阿皮克萨班和阿司匹林在患有密码性中风和心房心脏病的患者中发生的出血事件的发生率.
主要方法:
- 一个多中心,双盲,随机化试验比较阿皮克萨班和阿司匹林.
- 使用国际血栓与血液静止学会 (ISTH) 标准分类的出血事件.
- 年化发病率差异 (IRDs) 计算了安全性和治疗意向样本.
主要成果:
- 与阿司匹林相比,阿皮克萨班在安全性和治疗意图分析中显著减少了内出血.
- 在重大非内出血,任何重大出血或轻微出血风险方面没有发现显著差异.
- 虽然在安全样本中,阿皮克萨班的症状性内出血风险较低,但在治疗意图样本中,它没有达到统计学意义.
结论:
- 与阿司匹林相比,阿皮克萨班在患有密码性中风和心房心脏病的患者中降低了内出血的风险.
- 与阿司匹林相比,阿皮克萨班与任何类型的出血风险都没有增加.
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