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|本期目录/Table of Contents|

利伐沙班用于心房颤动导管消融术后抗凝治疗有效性及安全性

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2016年第1期
页码:
33-036
栏目:
临床研究
出版日期:
2015-09-15

文章信息/Info

Title:
Effectiveness and safety of anticoagulant therapy with rivaroxaban in patients after radiofrequency catheter ablation of atrial fibrillation
作者:
王 璇刘 婧王祖禄杨桂棠金志清梁 明韩雅玲
(沈阳军区总医院心内科,辽宁 沈阳 110016)
Author(s):
WANG Xuan LIU Jing WANG Zu-lu YANG Gui-tang JIN Zhi-qing LIANG Ming HAN Ya-ling
(Department of Cardiology, General Hospital, Shenyang Military Area Command, Shenyang 110016, Liaoning, China)
关键词:
心房颤动导管消融术抗凝治疗利伐沙班
Keywords:
atrial fibrillation radiofrequency catheter ablation oral anticoagulant rivaroxaban
分类号:
R541.6
DOI:
-
文献标识码:
A
摘要:
目的 评估利伐沙班用于心房颤动导管消融术后抗凝治疗的有效性及安全性。方法 将接受房颤射频导管消融的患者分为利伐沙班组(57例)和华法林组(100例)。利伐沙班组:房颤导管消融术后给予10 mg,2次/d或20 mg,1次/d口服,服用1个月后根据不同临床情况调整剂量,给予10 mg 1次/d或20 mg 1次/d再服用1个月。华法林组:房颤导管消融术后给予华法林3~6 mg/d,根据国际标准化比值(INR)调整剂量,控制INR在2.0~3.0,共服用2个月。所有患者从抗凝开始到抗凝结束选用同一种抗凝药物。结果 基线水平的比较除性别外其他指标均无统计学差异。两组有效性及安全性比较:华法林组和利伐沙班组均未发生血栓栓塞事件(死亡、脑栓塞、肺栓塞、体循环栓塞)。两组均无大出血事件发生;不明显出血事件利伐沙班组为5%(3/57)、华法林组为11%(11/100),差异无统计学意义。结论 口服利伐沙班用于血栓栓塞低、中危房颤患者导管消融术后抗凝安全有效。
Abstract:
AIM To evaluate the effectiveness and safety of anticoagulant therapy with rivaroxaban in patients after radiofrequency catheter ablation (RFCA) of atrial fibrillation (AF). METHODSA cohort of 157 patients who underwent RFCA for AF were enrolled. Patients were divided into rivaroxaban group (57 patients) and warfarin group (100 patients). In rivaroxaban group, rivaroxaban (10 mg, bid or 20 mg, QD) was given for 1 month, and then 20 mg daily or 10 mg daily for 1 more month according to the patient’s CHADS2 score. In the warfarin group, standard medication of warfarin was given for 2 months by adjusting the INR in the range between 2.0 and 3.0. RESULTSNo differences were observed in baseline characteristics between groups except for gender. For efficacy and safety, no differences were found between groups in the rates of death and thromboembolism events including cerebral, pulmonary and systemic emboli (0/57 cases in rivaroxaban group vs. 0/100 cases in warfarin group). There were no TIMI major bleeding events in either group and no significant differences were seen in minor bleeding events between rivaroxaban group and warfarin group (3/57 cases vs. 11/100 cases). CONCLUSIONCompared with oral warfarin, the effectiveness and safety of oral rivaroxaban could be safely and effectively used in AF patients with low or medium risk of thromboembolism after RFCA.

参考文献/References

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备注/Memo

备注/Memo:
收稿日期:2014-12-23.
>基金项目:辽宁省科学技术计划项目资助(2011408004);辽宁省自然科学基金项目资助(20102247)
通讯作者:王祖禄,主任医师,主要从事心律失常的基础与临床研究 Email:wangzl@medmail.com.cn
作者简介:王璇,住院医师,硕士 Email:wangxuan05@163.com
更新日期/Last Update: 2015-09-16