老年多病理性非瓣膜房颤患者的抗凝作用:利伐沙班的作用

Antoni Riera-Mestre , Miguel Camafort , Jose María Suriñach , Francisco José Muñoz Rodríguez , Ferran Padilla , Jaume Francisco-Pascual , José Mateo Arranz , Antonio Martínez Rubio , Roger Villuendas Sabaté , Román Freixa-Pamias , Carmen Suárez Fernández , Amparo Santamaría
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引用次数: 1

摘要

房颤常见于老年患者。尽管维生素K拮抗剂已被广泛使用多年,但它们在老年患者中有许多局限性,老年患者特别容易出血,而且抗凝控制比一般人群差。直接口服抗凝剂已被证明是这些患者更好的治疗选择,不仅因为它们使用更简单,而且因为它们比维生素K拮抗剂更有效和更安全。此外,他们在实践中的表现与关键临床试验中的表现基本一致。尽管如此,对老年患者仍存在给药剂量不适当的趋势,通常是剂量不足,特别是在某些亚组中。这可能导致对中风的保护减少,而出血风险没有明显降低。利伐沙班在老年人群中得到了广泛的研究,不仅在临床试验中,而且在常规临床实践的一系列研究中,研究结果高度一致。根据这些研究,与维生素K拮抗剂相比,利伐沙班降低了卒中的风险,而不增加致命性出血的发生率,对非瓣膜性心房颤动和血栓栓塞风险高的患者有净临床获益。
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Anticoagulación del paciente anciano pluripatológico con fibrilación auricular no valvular: papel del rivaroxabán

Atrial fibrillation is common in elderly patients. Although vitamin K antagonists have been widely used for many years, they have a number of limitations in elderly patients, who are particularly susceptible to bleeding and in whom anticoagulation control is poorer than in the general population. Direct oral anticoagulants have been shown to be a better therapeutic option for these patients, not only because they are simpler to use, but also because they are more effective and safer than vitamin K antagonists. Moreover, their performance in practice is generally consistent with that in pivotal clinical trials. Nevertheless, there is a tendency to administer inappropriate doses to elderly patients, generally underdosing, particularly in certain subgroups. This can result in less protection against stroke without any clear reduction in bleeding risk. Rivaroxaban has been widely studied in the elderly population, not only in clinical trials, but also in a range of studies in routine clinical practice – findings have been highly consistent. According to these studies, and compared to vitamin K antagonists, rivaroxaban reduces the risk of stroke without increasing the rate of fatal bleeding, with a net clinical benefit in patients with nonvalvular atrial fibrillation and a high thromboembolic risk.

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来源期刊
Revista Espanola de Cardiologia Suplementos
Revista Espanola de Cardiologia Suplementos Medicine-Cardiology and Cardiovascular Medicine
CiteScore
1.20
自引率
0.00%
发文量
1
期刊介绍: Revista Española de Cardiología, is an international scientific journal dealing with cardiovascular medicine. Revista Española de Cardiología, the official publication of the Spanish Society of Cardiology, publishes research articles related to cardiovascular diseases. Articles are published in Spanish for the paper edition and in both Spanish and English in the electronic edition, which is available on the Internet. Regular sections include original articles reporting clinical or basic research, brief reports, review articles, editorials and letters to the Editor.
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