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首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >The Comparison of Inappropriate-Low-Doses Use among 4 Direct Oral Anticoagulants in Patients with Atrial Fibrillation: From the Database of a Single-Center Registry
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The Comparison of Inappropriate-Low-Doses Use among 4 Direct Oral Anticoagulants in Patients with Atrial Fibrillation: From the Database of a Single-Center Registry

机译：在心房颤动患者中的4个直腹抗凝血剂中的不合适 - 低剂量使用的比较：从单中心登记处的数据库

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BackgroundInappropriate doses of direct oral anticoagulants (DOACs) are often prescribed. This study evaluated the prevalence, outcomes, and predictors of the prescription of inappropriately low doses of 4 types of DOACs in patients with atrial fibrillation (AF). MethodsWe retrospectively analyzed prospectively collected data from a single-center registry with 2272 patients prescribed DOACs for AF (apixaban: 1014; edoxaban: 267; rivaroxaban: 498; dabigatran: 493). Patients were monitored for 2years and classified into appropriate-dose (n?=?1,753; including appropriate low doses), inappropriate-low-dose (n?=?490) and inappropriate-high-dose groups (n?=?29). Major bleeding (MB) and thromboembolic events (TEEs) were evaluated. ResultsThe mean age was 72 ± 10years. The CHADS2and HAS-BLED scores were 1.95 ± 1.32 and 1.89 ±.96, respectively. Overall, the incidences of MB and TEE were 2.3 and 2.1 per 100-patinet year, respectively. The inappropriate-low-dose group had younger age, heavier body weight, and higher creatinine clearance value than the appropriate-dose group. Multiple logistic regression analyses demonstrated the following independent determinants of the prescription of an inappropriately low dose: apixaban: HAS-BLED score; edoxaban: age; rivaroxaban: age, creatinine clearance value, HAS-BLED score, CHADS2score, and antiplatelet therapy; dabigatran: age. There were not significant differences in the incidence of major bleeding and stroke/systemic emboli among the inappropriate-low-dose group of 4 DOACs compared with the appropriate-dose group of 4 DOACs. ConclusionsIn a single-center registry, 23% of patients with AF treated with a DOAC received an inappropriate dose. Several clinical factors, such as age and the creatinine clearance value, can identify patients at risk of under-treatment with DOACs.
机译：背景不恰当的次抗凝血剂（Doacs）通常是规定的。该研究评估了心房颤动患者不恰当低剂量的4种DOAC的患病率，结果和预测因子（AF）。方法网络回顾性地分析了从单中心注册表的预期收集数据，其中2272名患者为AF规定的DOACS（Apixaban：1014; eDoxaban：267; Rivaroxaban：498; Dabigatran：493）。患者被监测2年，并分类为适当剂量（n？= 1,753;包括适当的低剂量），低剂量（n？=Δ490）和不适当的高剂量组（n？=？29） 。评估主要出血（MB）和血栓栓塞事件（TEES）。结果均值年龄为72±10年。 Chads2和Bled得分分别为1.95±1.32和1.89±.96。总体而言，MB和TEE的发条分别为每100个Patinet年为2.3和2.1。不合适的低剂量组年龄较小，体重重小，较高的肌酐清除值比合适剂量组更高。多重逻辑回归分析证明了以下独立的决定因素的处方不恰当​​的低剂量：Apixaban：具有Bled得分; Edoxaban：年龄; Rivaroxaban：年龄，肌酐清除价值，具有Bled得分，ChAds2score和抗血小板治疗; Dabigatran：年龄。与4个DoACs的适当剂量组相比，在4个DoAC中的不适当的低剂量组中，主要出血和中风/全身栓塞的发生率没有显着差异。结论单一中心注册表，23％的患者AF治疗DOAC治疗不适当的剂量。几种临床因素，如年龄和肌酐清除值，可以识别患者患者患有Doacs的危险。

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