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山东大学学报(医学版) ›› 2015, Vol. 53 ›› Issue (11): 37-40.doi: 10.6040/j.issn.1671-7554.0.2015.147

• 临床医学 • 上一篇    下一篇

达比加群酯预防非瓣膜性房颤患者血栓栓塞的有效性和安全性

吕岩红, 高海青, 邱洁   

  1. 1.山东大学齐鲁医院老年病科, 山东 济南 250012;
    2.山东省心血管蛋白质组学重点实验室, 山东 济南 250012
  • 收稿日期:2015-02-03 出版日期:2015-11-10 发布日期:2015-11-10
  • 通讯作者: 邱洁.E-mail:drqiujie@163.com E-mail:drqiujie@163.com
  • 基金资助:
    国家科技部重大科技攻关项目子课题(20122×09303016-003)

Efficacy and safety of dabigatran etexilate versus warfarin in antithrombotic therapy for nonvalvular atrial filbrillation

LÜ Yanhong, GAO Haiqing, QIU Jie   

  1. 1. Department of Geratology, Qilu Hospital of Shandong University, Jinan 250012, Shandong, China;
    2. Shandong Key Laboratory of Cardiovascular Proteomics, Jinan 250012, Shandong, China
  • Received:2015-02-03 Online:2015-11-10 Published:2015-11-10

摘要: 目的 比较达比加群酯和调整剂量的华法林预防非瓣膜性房颤患者血栓栓塞的有效性和安全性.方法 选取2013年9月至2014年6月收治的166例非瓣膜性房颤患者进行回顾性分析,分为达比加群酯组(110 mg/次,2次/d)和华法林组(初始剂量为2.5 mg/d),国际标准化比值(INR)在2.0~3.0之间.随访6个月,比较两组血栓栓塞事件及出血事件的发生情况.结果 有效性终点指标:达比加群酯组无血栓栓塞事件的发生,华法林组发生缺血性脑卒中1例,两组患者血栓栓塞事件发生率差异无统计学意义(0.0% vs 1.2%, P>0.05);安全性终点指标:两组均无重要出血事件发生,达比加群酯组发生轻微出血事件4例,华法林组发生轻微出血事件5例,两组患者出血事件发生率差异无统计学意义(P>0.05).结论 达比加群酯预防非瓣膜性房颤患者血栓栓塞的有效性和安全性与华法林相当.

关键词: 达比加群酯, 非瓣膜性房颤, 华法林, 血栓栓塞

Abstract: Objective To compare the efficacy and safety of dabigatran etexilate with warfarin for thromboembolism prevention in patients with nonvalvular atrial fibrillation. Methods A total of 166 patients with nonvalvular atrial fibrillation were identified as dabigatran etexilate group (110 mg, twice daily) and warfarin group (target international normalized ratio, 2.0~3.0). The efficacy and safety of the two drugs were compared in regard to stroke or systemic embolism and major bleeding outcomes during a follow-up of 6 months. Results In the thromboembolism events, there was no significant difference between dabigatran etexilate group and warfarin group (0.0% vs 1.2%, P>0.05). The rate of bleeding was 4.82% in the dabigatran etexilate group, as compared with 6.02% in the warfarin group (P>0.05). Conclusion There are similar thromboembolism and bleeding rates in patients with nonvalvular atrial fibrillation between dabigatran etexilate and warfarin.

Key words: Dabigatran etexilate, Thromboembolism, Nonvalvular atrial filbrillation, Warfarin

中图分类号: 

  • R541.7
[1] Olsson LG, Swedberg K, Lappas G, et al. Trends in stroke incidence after hospitalization for atrial fibrillation in Sweden 1987 to 2006[J]. Int J Cardiol, 2013, 167(3): 733-738.
[2] Wolf PA, Abbott RD, Kannel WB. Atrial fibrillation as an independent risk factor for stroke: the Framingham Study[J]. Stroke, 1991, 22(8): 983-988.
[3] Flegel KM, Shipleya MJ, Rose G. Risk of stroke in non-rheumatic atrial fibrillation[J]. Lancet, 1987, 1(8532): 526-529.
[4] Marini C, De Santis F, Sacco S, et al. Contribution of atrial fibrillation to incidence and outcome of ischemic stroke: results from a population-based study[J]. Stroke, 2005, 36(6): 1115-1119.
[5] Lin HJ, Wolf PA, Kelly-Hayes M, et al. Stroke severity in atrial fibrillation. The Framingham Study[J]. Stroke, 1996, 27(10): 1760-1764.
[6] Stewart S, Hart CL, Hole DJ, et al. Population prevalence, incidence, and predictors of atrial fibrillation in the Renfrew/Paisley study[J]. Heart, 2001, 86(5): 516-521.
[7] Go AS, Hylek EM, Phillips KA, et al. Prevalence of diagnosed atrial fibrillation in adults: national implications for rhythm management and stroke prevention: the Anticoagulation and Risk Factors in Atrial Fibrillation (ATRIA) Study[J]. JAMA, 2001, 285(18): 2370-2375.
[8] Heeringa J, van der Kuip DA, Hofman A, et al. Prevalence, incidence and lifetime risk of atrial fibrillation: the Rotterdam study[J]. Eur Heart J, 2006, 27(8): 949-953.
[9] 周自强, 胡大一, 陈捷, 等. 中国心房颤动现状的流行病学研究[J]. 中华内科杂志, 2004, 43: 491-494.
[10] Hu D, Sun Y. Epidemiology, risk factors for stroke, and management of atrial fibrillation in China[J]. J Am Coll Cardiol, 2008, 52(10): 865-868.
[11] Stangier J. Clinical pharmacokinetics and pharmacodynamics of the oral direct thrombin inhibitor dabigatran etexilate[J]. Clin Pharmacokinet, 2008, 47(5): 285-295.
[12] Stangier J, Rathgen K, Stahle H, et al. Influence of renal impairment on the pharmacokinetics and pharmacodynamics of oral dabigatran etexilate: an open label, parallel-group, single-centre study[J]. Clin Pharmacokinet, 2010, 49(4): 259-268.
[13] Connolly SJ, Ezekowitz MD, Yusuf S, et al. Dabigatran versus warfarin in patients with atrial fibrillation[J]. N Engl J Med, 2009, 361(12): 1139-1151.
[14] Hori M, Connolly SJ, Zhu J, et al. Dabigatran versus warfarin: effects on ischemic and hemorrhagic strokes and bleeding in Asians and non-Asians with atrial fibrillation[J]. Stroke, 2013, 44(7): 1891-1896.
[15] Eikelboom JW, Wallentin L, Connolly SJ, et al. Risk of bleeding with 2 doses of dabigatran compared with warfarin in older and younger patients with Aatrial fibrillation: an analysis of the randomized evaluation of long-term anticoagulant therapy (RE-LY) trial[J]. Circulation, 2011, 123(21): 2363-2372.
[16] Nagarakanti R, Ezekowitz MD, Oldgren J, et al. Dabigatran versus warfarin in patients with atrial fibrillation an analysis of patients undergoing cardioversion[J]. Circulation, 2011, 123(2): 131-136.
[17] Providencia R, Albenque JP, Combes S, et al. Safety and efficacy of dabigatran versus warfarin in patients undergoing catheter ablation of atrial fibrillation: a systematic review and meta-analysis[J]. Heart, 2014, 100(4): 324-335.
[18] Larsen TB, Rasmussen LH, Skjoth F, et al. Efficacy and safety of dabigatran etexilate and warfarin in "real-world" patients with atrial fibrillation: a prospective nationwide cohort study[J]. J Am Coll Cardiol, 2013, 6(22): 2264-2273.
[19] Eikelboom JW, Connolly SJ, Brueckmann M, et al. Dabigatran versus warfarin in patients with mechanical heart valves[J]. N Engl J Med, 2013, 369(13): 1206-1214.
[20] January CT, Wann LS, Alpert JS, et al. 2014 AHA/ACC/HRS guideline for the management of patients with atrial fibrillation: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the Heart Rhythm Society[J]. J Am Coll Cardiol, 2014, 64(21): 1-76.
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