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首页> 外文期刊>Circulation journal >Changing Treatment Patterns in Patients With Venous Thromboembolism in Taiwan
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Changing Treatment Patterns in Patients With Venous Thromboembolism in Taiwan

机译：台湾静脉血栓栓塞患者改变治疗模式

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Background: In Asia, little information is available about contemporary real-world treatment patterns for venous thromboembolism (VTE). Methods?and?Results: Consecutive patients (n=11,414) from the Taiwan National Health Insurance Research Database with initial VTE and taking oral anticoagulants between May 1, 2014 and June 30, 2016 were included. The temporal trends of using oral anticoagulants and pharmacomechanical therapy during the study period were evaluated. The efficacy and safety of nonvitamin K antagonist oral anticoagulants (NOACs) vs. warfarin were compared. Propensity score analysis (NOACs n=3,647 vs. warfarin n=3,647) was used to balance covariates between groups, and Cox proportional hazards models with adjustment were used to estimate the risks of clinical outcomes. The use of NOACs increased from 0.3% to 60.2% for VTE treatment during the study period. Pharmacomechanical therapy was used in 9.60%, 8.22%, and 5.63% from 2014 through 2016. NOACs were associated with a 16% risk reduction (adjusted hazard ratio [aHR] 0.84, 95% confidence interval [CI] 0.77–0.93) in all-cause mortality and a 21% risk reduction (aHR 0.79, 95% CI 0.65–0.96) in recurrent VTE vs. warfarin. Overall, NOACs were associated with a lower risk of major bleeding compared with warfarin (aHR 0.804, 95% CI 0.648–0.998). Conclusions: In real-world practice, NOACs have become the major anticoagulant used for Asians with VTE. Although NOACs had a lower risk of recurrent VTE and major bleeding compared with warfarin in Taiwan, we still need a large-scale randomized controlled trial to confirm the findings.
机译：背景：在亚洲，静脉血栓栓塞（VTE）的当代现实世界治疗模式的少数信息很少。方法？结果：来自台湾国家健康保险研究数据库的连续患者（n = 11,414），其中包括初始vteb和2016年5月30日和2016年6月30日之间的口服抗凝血剂。评估了在研究期间使用口服抗凝剂和药物机械治疗的时间趋势。比较非vitamin K拮抗剂口腔抗凝血剂（NOACS）对阵华法林的疗效和安全性。倾向评分分析（Noacs n = 3,647 vs.Warfarin n = 3,647）用于平衡组之间的协调因子，并使用调整的Cox比例危险模型来估算临床结果的风险。在研究期间，Noacs的使用从VTE治疗增加0.3％至60.2％。从2014年至2016年使用药物机械疗法的9.60％，8.22％和5.63％。Noacs与所有风险降低风险降低有16％（调整的危险比[AHR] 0.84,95％置信区间[CI] 0.77-0.93）。在复发性VTE与华法林中，死亡率和21％的风险降低（AHR 0.79,95％CI 0.65-0.96）。总体而言，与华法林（AHR 0.804,95％CI 0.648-0.998）相比，Noacs与重大出血的风险较低。结论：在真实世界的实践中，Noacs已成为与VTE的亚洲人使用的主要抗凝血剂。尽管与台湾的华法林相比，Noacs具有较低的经常性VTE和重大出血的风险，但我们仍需要大规模随机对照试验来确认调查结果。

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