Eur Heart J:伴肾衰竭的房颤患者可安全应用抗栓治疗

2014-04-21 高晓方 译 医学论坛网

瑞典一项研究表明,大部分伴肾衰竭的房颤患者可从房颤推荐血栓预防治疗中获益,并且无需设置更高或更低的治疗阈值。增加肾衰竭附加分的CHADS2和CHA2DS2-VASc分数并未提高预测价值。论文于4月9日在线发表于《欧洲心脏杂志》(Eur Heart J)。 此项回顾性非随机研究共纳入307351例房颤患者,其中13435例既往被诊断为肾衰竭。依据抗凝策略不同,在伴有肾衰竭的房颤患者中对缺血性卒

瑞典一项研究表明,大部分伴肾衰竭的房颤患者可从房颤推荐血栓预防治疗中获益,并且无需设置更高或更低的治疗阈值。增加肾衰竭附加分的CHADS2和CHA2DS2-VASc分数并未提高预测价值。论文于4月9日在线发表于《欧洲心脏杂志》(Eur Heart J)。

此项回顾性非随机研究共纳入307351例房颤患者,其中13435例既往被诊断为肾衰竭。依据抗凝策略不同,在伴有肾衰竭的房颤患者中对缺血性卒中和出血风险加以确定。

结果显示,伴肾衰竭的房颤患者更有可能出现缺血性卒中,但其与并存疾病具有相关性。将肾衰竭添加至确定性卒中风险分层方案未能改善其预测价值。肾衰竭为颅内出血的独立危险因素(校正HR 1.27)。尽管存在高出血风险,但大部分肾衰竭患者可从华法林治疗中获益。华法林应用者的缺血或出血性卒中及死亡复合终点发生率低于未应用者(校正HR 0.76)。

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    2014-04-23 zhaojie88
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