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首页> 外文期刊>The American Journal of Cardiology >Comparison of Characteristics and Outcomes of Dabigatran Versus Warfarin in Hypertensive Patients With Atrial Fibrillation (from the RE-LY Trial)
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Comparison of Characteristics and Outcomes of Dabigatran Versus Warfarin in Hypertensive Patients With Atrial Fibrillation (from the RE-LY Trial)

机译：高血压房颤患者达比加群与华法林的特征和结果比较（来自RE-LY试验）

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摘要

Hypertension is frequent in patients with atrial fibrillation (AF) and is an independent risk factor for stroke. The Randomized Evaluation of Long Term Anticoagulant TherapY (RE-LY) trial found dabigatran 110 mg (D110) and 150 mg twice daily (D150) noninferior or superior to warfarin for stroke reduction in patients with AF, with either a reduction (D110) or similar rates (D150) of major bleeding. Baseline characteristics and outcomes were compared in patients with and without hypertension. The quality of blood pressure control was also assessed. In RE-LY, 14,283 patients (78.9%) had hypertension. The mean blood pressure at baseline was 132.6 +/- 17.6/77.7 +/- 10.6 and 124.8 +/- 16.7/74.6 +/- 10.0 mm Hg for patients with and without hypertension, respectively. More patients with hypertension were diabetic (25.6% vs 14.8%, p <0.001), women (38.6% vs 28.3%, p <0.001), and had greater CHADS(2) (2.3 vs 1.4, p <0.001) and CHA(2)DS(2)-VASc scores (3.8 vs 2.8, p <0.001). Mean blood pressure in all treatment arms in hypertensive patients was similar (130 +/- 18/76 +/- 11 mm Hg) during the trial. The efficacy and safety of D110 and D150 compared to warfarin were similar (p = nonsignificant) in hypertensive (stroke/systemic embolism rate of 1.47%, 1.20%, and 1.81% and major bleed rate of 2.89%, 3.70%, and 3.69% in the D110, D150, and W, respectively) and normotensive patients (stroke/systemic embolism rate of 1.79%, 0.78%, and 1.36% and major bleed rate of 2.84%, 2.37%, and 3.03% per year in the D110, D150, and W, respectively). Hypertensive patients had more major bleeds (3.39% vs. 2.76%; p = 0.007). Intracranial bleeds were similar (0.47% vs 0.31%; p = 0.12). In conclusion, patients with hypertension in RE-LY were more likely female, diabetic, with a greater CHADS(2) and CHA(2)DS(2)-VASc scores. Blood pressure control in RE-LY was excellent. The benefits of dabigatran over warfarin, including a substantial reduction of intracranial hemorrhage, were similar in both hypertensive and non-hypertensive patients. (C) 2015 Elsevier Inc. All rights reserved.
机译：心房颤动（AF）患者经常患有高血压，并且是卒中的独立危险因素。长期抗凝治疗的随机评估（RE-LY）试验发现，达比加群110 mg（D110）和150 mg每日两次（D150）在房颤患者的卒中减少方面均不劣于或优于华法林，或降低（D110）或降低大出血的发生率（D150）相似。比较了有高血压和无高血压患者的基线特征和预后。还评估了血压控制的质量。在RE-LY中，有14283名患者（78.9％）患有高血压。患有和不患有高血压的患者的基线平均血压分别为132.6 +/- 17.6 / 77.7 +/- 10.6和124.8 +/- 16.7 / 74.6 +/- 10.0 mm Hg。患有糖尿病的高血压患者更多（25.6％vs 14.8％，p <0.001），女性（38.6％vs 28.3％，p <0.001），且CHADS（2）（2.3 vs 1.4，p <0.001）和CHA（ 2）DS（2）-VASc评分（3.8 vs 2.8，p <0.001）。在试验期间，高血压患者所有治疗组的平均血压相似（130 +/- 18/76 +/- 11毫米汞柱）。与华法林相比，D110和D150的功效和安全性在高血压（中风/全身栓塞发生率分别为1.47％，1.20％和1.81％）和主要出血发生率分别为2.89％，3.70％和3.69％方面相似（p =无显着性） D110，D150和W分别为血压正常的患者（中风/全身性栓塞发生率分别为1.79％，0.78％和1.36％，D110的每年大出血率为2.84％，2.37％和3.03％）， D150和W）。高血压患者有更多的大出血（3.39％vs. 2.76％; p = 0.007）。颅内出血相似（0.47％vs 0.31％; p = 0.12）。总之，在RE-LY中患有高血压的患者更有可能是女性，糖尿病患者，其CHADS（2）和CHA（2）DS（2）-VASc评分更高。 RE-LY的血压控制非常好。在高血压和非高血压患者中，达比加群优于华法林的益处，包括颅内出血的大量减少，均相似。 （C）2015 Elsevier Inc.保留所有权利。

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