Efallai mai Apixaban yw'r DOAC Gorau ar gyfer Cleifion Eiddil, Hŷn ag AF
Gadewch neges
Apixabanisnotsuperiortotraditionaltreatmentmethodsaftertranscatheteraorticvalvereplacement (TAVR), yn ôloneoneatapresentedatACC.21, theAmericanCollegeofCardiology's70thannualscientificsession.
Mae ymchwilwyrhavepreviousfoundthatapixaban, anon-fitaminKantagonistoralanticoagulant, canprovidesignificantvaluewhentreatingsomesubsetsofpatientswithatrialfibrillation.The
teambehindtheATLANTIStrialaimedtolearnifapixabanmightmakeasimilarimpactonTAVRpatients, cymharuitssafetyandeffectivenesstomoretraditionaltreatmentoptionssuchasvitaminKantagonists (VKAs) oraspirin.
Theanalysisincludedmorethan1,500patientswhounderwentasuccessfulTAVRprocedurefrom2016to2019inoneoffourdifferentcountries.Approximatelyoneinthreepatientsrequiredanticoagulationtherapyforareasonotherthantheprocedure; halfofthosepatientsweretreatedwithapixaban, andtheotherhalfweretreatedwithwarfarin, aVKA.Amongpatientswhodidnotrequireanticoagulation, halfweretreatedwithapixaban, andtheotherhalfweretreatedwithantiplateletmedicationsuchasaspirin.
Ar y cyfan, afteroneyear, therewasnosignificantdifferenceinthecompositeendpointofall-causemortality, strôc, heartattack, valvethrombosis, pulmonaryorsystemicembolism, deepveinthrombosisormajorbleedingevents.Whileoneofthoseoutcomeswerereportedin18.4% ofpatientstakingapixaban, theyoccurredin20.1% ofpatientswhoweretakingeitherwarfarinorantiplateletmedication.Thismaytechnicallybeanimprovement, butthedifferencebetweenthetwogroupswasstillnotstatisticallysignificant.
Perhapsthesinglebiggesttakeawayfromtheteam'sworkisthatapixabandidappeartohelplimitbloodclotsinTAVRpatients - butaintypatientswhodidnotrequireanticoagulationexperiencedheightenedratesofnon-cardiovascularmortality.