利伐沙班对合并心功能不全的高龄非瓣膜性心房颤动疗效及安全性

doi:10.3969/j.issn.1004-583X.2020.05.005

临床荟萃

利伐沙班对合并心功能不全的高龄非瓣膜性心房颤动疗效及安全性

临夏回族自治州人民医院心内科，甘肃临夏 731100

出版日期:2020-05-20 发布日期:2020-04-27
通讯作者: 马进才，Email: vde2kw@163.com

Efficacy and safety of rivaroxaban in elderly patients with nonvalvular atrial fibrillation complicated with cardiac insufficiency

Department of Cardiovascular Medicine, People's Hospital of Linxia Hui Autonomous Prefecture, Linxia 731100, China

Online:2020-05-20 Published:2020-04-27
Contact: Corresponding author: Ma Jincai, Email:vde2kw@163.com

摘要/Abstract

摘要： 目的分析利伐沙班对合并心功能不全的高龄非瓣膜性心房颤动（nonvalvular atrial fibrillation，NVAF）患者临床疗效及安全性。方法随机连续纳入2016年1月至2020年1月间就诊于我院合并心功能不全的高龄NVAF患者182例，随机分为两组，其中91例患者应用利伐沙班抗凝归为观察组，余91例应用华法林抗凝归为对照组。随访记录两组抗凝期间血栓事件、出血等不良反应以及凝血功能和心功能情况。结果观察组总出血事件显著低于对照组；观察组治疗后N末端B型利钠肽前体（NTproBNP）较对照组显著下降；COX风险模型发现，年龄及华法林是不良事件的危险因素。结论利伐沙班对于合并心功能不全的高龄NVAF患者疗效不劣于华法林，但安全性显著高于华法林。

关键词: 心房颤动, 非瓣膜性, 利伐沙班, 心功能不全, 高龄, 疗效, 安全性

Abstract: Objective To analyze the clinical efficacy and safety of rivaroxabanin elderly patients with nonvalvular atrial fibrillation (NVAF) complicated with cardiac insufficiency. Methods A total of 182 elderly NVAF patients complicated with cardiac insufficiency who were admitted to the hospital from January 2016 to January 2020 were enrolled. The patients were randomly divided into two groups, 91 cases were selected for rivaroxaban anticoagulation as observation group, and other 91 cases were treated with warfarin anticoagulation as control group. The adverse events including thrombotic events, hemorrhage, and coagulation, as well as the coagulation function and cardiac function were recorded during the followup in two groups. Results The total bleeding events in observation group were significantly lower than those in control group. NTproBNP of observation group significantly decreased compared with that of control group after treatment. COX risk model found that the age and warfarin were risk factors for adverse events. Conclusion Rivaroxaban is not inferior to warfarin in treating the elderly NVAF patients complicated with cardiac insufficiency, but its safety is significantly higher than that of warfarin.

Key words: atrial fibrillation, nonvalvular; , rivaroxaban, cardiac insufficiency; , the elderly; , efficacy, safety

马进才，马溶智，马珍珍. 利伐沙班对合并心功能不全的高龄非瓣膜性心房颤动疗效及安全性[J]. 临床荟萃, doi: 10.3969/j.issn.1004-583X.2020.05.005.

Ma Jincai, Ma Rongzhi, Ma Zhenzhen. Efficacy and safety of rivaroxaban in elderly patients with nonvalvular atrial fibrillation complicated with cardiac insufficiency[J]. Clinical Focus, doi: 10.3969/j.issn.1004-583X.2020.05.005.

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链接本文: https://huicui.hebmu.edu.cn/CN/10.3969/j.issn.1004-583X.2020.05.005

https://huicui.hebmu.edu.cn/CN/Y2020/V35/I5/413

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利伐沙班对合并心功能不全的高龄非瓣膜性心房颤动疗效及安全性

Efficacy and safety of rivaroxaban in elderly patients with nonvalvular atrial fibrillation complicated with cardiac insufficiency

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