利伐沙班在高龄心力衰竭合并房颤抗凝治疗中的剂量优化研究

doi:10.3969/j.issn.1003-9198.2022.10.013

Abstract

Abstract: Objective To study the dose optimization of rivaroxaban in the anticoagulant treatment of heart failure complicated with atrial fibrillation in the patients aged ＞80 years. Methods The clinical data of 85 elderly patients with heart failure complicated with atrial fibrillation in our hospital from February 2018 to February 2021 were collected retrospectively. According to the prescription dose of rivaroxaban, they were divided into low dose group (5 mg/d, n=25), medium dose group (10 mg/d, n=41) and high dose group (20 mg/d, n=19). The indexes of coagulation function [prothrombin time (PT), D-dimer (D-D)] and cardiac function [left ventricular ejection fraction (LVEF), pulmonary artery pressure (PAP), N-terminal B-type natriuretic peptide precursor (NT-proBNP)] were compared before treatment and 1 month after treatment, and all patients were followed up for 6 months. Results There were no significant differences in PT and D-D between the three groups before and after treatment (P>0.05). After treatment, the level of PT was longer and the level of D-D was lower than that before treatment in the three groups (P< 0.05). There were no significant differences in the levels of LVEF, PAP and NT-proBNP between the three groups before and after treatment (P>0.05). After treatment, the level of LVEF in the three groups was higher than that before treatment, and the levels of PAP and NT-proBNP were lower than those before treatment (P<0.05). In the middle dose group, the total embolism rate was lower than that in the low dose group (P<0.05), while the total incidence rate of bleeding was lower than that in the high dose group (P<0.05). Conclusions For elderly patients with heart failure complicated with atrial fibrillation, rivaroxaban can improve the coagulation function and cardiac function, and 10 mg/d may be the best dose of anticoagulant therapy.

Key words: aged, heart failure, atrial fibrillation, rivaroxaban, dose optimization

CLC Number:

R541

XU Yu-wen, LIU Qiong, SHEN Qiong, ZHU Yan, FANG Hong-jun. Dose optimization of rivaroxaban in anticoagulant therapy for elderly patients with heart failure complicated with atrial fibrillation[J]. Practical Geriatrics, 2022, 36(10): 1028-1032.

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Dose optimization of rivaroxaban in anticoagulant therapy for elderly patients with heart failure complicated with atrial fibrillation

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