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Oral anticoagulant therapy safely prevented stroke in older patients with atrial fibrillation

机译:口服抗凝治疗可安全预防老年房颤患者的中风

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摘要

QuestionrnIn patients with atrial fibrillation, do the effectiveness and safetyrnof oral anticoagulant (OAC) and antiplatelet (AP) therapies forrnstroke prevention change with age?rnMethodsrnDesign: Individual patient data meta-analysis of 12 randomizedrncontrolled trials (RCTs). 6 RCTs were placebo-controlled;rn8 RCTs compared an OAC with an AP.rnBlinding: Outcome adjudication committee was blinded inrn11 trials.rnFollow-up period: Mean 2 years.rnPatients: 8932 adults (mean age 72 y, 63% men) with nonvalvularrnatrial fibrillation. Patients with clinical indications for or againstrnany of the active therapies were excluded.rnInterventions: Full-dose OACs (mainly warfarin sodium orrn4-hydroxycoumarin) with lower target international normalizedrnratio (INR) of 1.5 to 2.8 and upper target INR of 2.7 to 4.2rn(n = 3430); APs (mainly acetylsalicylic acid, 75 to 325 mg) withrnor without low-dose OACs (median INR < 1.5) (n = 3531); orrnplacebo (n = 1971).rnOutcomes: Ischemic stroke, serious bleeding, and cardiovascularrnevents (ischemic stroke, myocardial infarction, systemicrnembolism, or vascular death). Intention-to-treat analysis.
机译:问题对于房颤患者,口服抗凝药(OAC)和抗血小板(AP)疗法的有效性和安全性是否会随着年龄的增长而改变? 6项RCT是安慰剂对照的; rn 8项RCT将OAC与AP进行了比较。rn盲法:结果评审委员会在rn11试验中不知情。非瓣膜性房颤。干预措施:全剂量OAC(主要是华法令钠orrn4-羟基香豆素),国际目标标准化INR(INR)较低,为1.5-2.8,目标INR上限为2.7-4.2rn( n = 3430);无小剂量OAC的AP(主要是乙酰水杨酸,75至325 mg)(中位数INR <1.5)(n = 3531);结果:缺血性中风,严重出血和心血管事件(缺血性中风,心肌梗塞,系统性栓塞或血管性死亡)。意向治疗分析。

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  • 来源
    《ACP Journal Club》 |2009年第1期|p.4-4|共1页
  • 作者

    Andrew Dunn MD;

  • 作者单位

    Mount Sinai School of MedicineNew York, New York, USA;

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  • 正文语种 eng
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