当前位置：
X-MOL 学术
›
Thromb. J.
›
论文详情
Our official English website, www.x-mol.net, welcomes your feedback! (Note: you will need to create a separate account there.)
Safety and efficacy of direct oral anticoagulants in stroke prevention in patients with atrial fibrillation complicated with anemia and/or thrombocytopenia: a retrospective cohort study
Thrombosis Journal ( IF 3.1 ) Pub Date : 2023-11-21 , DOI: 10.1186/s12959-023-00563-7 Wenlin Xu 1 , Jiana Chen 1 , Shuyi Wu 1 , Nianxu Huang 2 , Xia Chen 3 , Wang Zhang 4 , Wei Hu 5 , Jun Su 6 , Hengfen Dai 7 , Ping Gu 8 , Xiaohong Huang 9 , Xiaoming Du 10 , Ruijuan Li 11 , Qiaowei Zheng 12 , Xiangsheng Lin 13 , Yanxia Zhang 14 , Lang Zou 15 , Yuxin Liu 16 , Min Zhang 17 , Xiumei Liu 18 , Zhu Zhu 19 , Jinhua Zhang 1
Thrombosis Journal ( IF 3.1 ) Pub Date : 2023-11-21 , DOI: 10.1186/s12959-023-00563-7 Wenlin Xu 1 , Jiana Chen 1 , Shuyi Wu 1 , Nianxu Huang 2 , Xia Chen 3 , Wang Zhang 4 , Wei Hu 5 , Jun Su 6 , Hengfen Dai 7 , Ping Gu 8 , Xiaohong Huang 9 , Xiaoming Du 10 , Ruijuan Li 11 , Qiaowei Zheng 12 , Xiangsheng Lin 13 , Yanxia Zhang 14 , Lang Zou 15 , Yuxin Liu 16 , Min Zhang 17 , Xiumei Liu 18 , Zhu Zhu 19 , Jinhua Zhang 1
Affiliation
There are limited data about the clinical benefits and harm of direct oral anticoagulants (DOACs) in stroke prevention in patients with atrial fibrillation (AF) complicated with anemia or thrombocytopenia. This is a multi-center retrospective cohort study involving 5469 AF patients from 15 hospitals in China. Patients were divided into three groups according to hemoglobin and platelet levels: Group 1 (hemoglobin male ≥ 130 g/L; female ≥ 120 g/L and platelet ≥ 100 × 109/L), Group 2 (hemoglobin male < 130 g/L; female < 120 g/L or platelet < 100 × 109/L), and Group 3 (hemoglobin male < 130 g/L; female < 120 g/L and platelet < 100 × 109/L). Patients in each category are further divided into two groups according to their stroke prevention strategies: rivaroxaban or dabigatran. Clinical results include major, minor, total bleeding, thrombosis, and the composite outcome of major bleeding and thrombosis. Higher hemoglobin levels were associated with a reduced risk of total bleeding and major bleeding, while platelet counts were not associated with any event. Compared with Group 1, Group 2 had a higher risk of major bleeding (aOR 1.70, 95%CI 1.12–2.57, P = 0.012), and the composite endpoint of major bleeding and thrombosis (aOR 1.70, 95%CI 1.19–2.44, P = 0.004). Compared with Group 1, Group 3 had a higher total bleeding risk (aOR 2.15, 95%CI 1.14–4.05, P = 0.018). Compared with dabigatran, rivaroxaban was associated with higher composite risk in Group 1 (aOR 2.91, 95% CI 1.66–5.16, P < 0.001) and Group 2 (aOR 3.05, 95%CI 1.46–6.39, P = 0.003), but there was no significant difference in Group 3 (aOR 1.78, 95%CI 0.23—13.54, P = 0.577). Higher hemoglobin levels are associated with a reduced risk of total bleeding and major bleeding in patients with AF. Dabigatran was associated with better clinical outcomes than rivaroxaban in patients with anemia or thrombocytopenia but not in those with anemia and thrombocytopenia.
更新日期：2023-11-22
京公网安备 11010802027423号