利伐沙班用于心房颤动导管消融术后抗凝治疗有效性及安全性  

Effectiveness and safety of anticoagulant therapy with rivaroxaban in patients after radiofrequency catheter ablation of atrial fibrillation

作　　者：王璇[1] 刘婧[1] 王祖禄[1] 杨桂棠[1] 金志清[1] 梁明[1] 韩雅玲[1] 

机构地区：[1]沈阳军区总医院心内科,辽宁沈阳110016

出　　处：《心脏杂志》2016年第1期33-36,共4页Chinese Heart Journal

基　　金：辽宁省科学技术计划项目资助(2011408004);辽宁省自然科学基金项目资助(20102247)

摘　　要：目的评估利伐沙班用于心房颤动导管消融术后抗凝治疗的有效性及安全性。方法将接受房颤射频导管消融的患者分为利伐沙班组（57例）和华法林组（100例）。利伐沙班组：房颤导管消融术后给予10mg，2次／d或20mg，1次／d口服，服用1个月后根据不同临床情况调整剂量，给予10mg1次／d或20mg17＆／d再服用1个月。华法林组：房颤导管消融术后给予华法林3—6mg／d，根据国际标准化比值（INR）调整剂量，控制INR在2．0—3．0，共服用2个月。所有患者从抗凝开始到抗凝结束选用同一种抗凝药物。结果基线水平的比较除性别外其他指标均无统计学差异。两组有效性及安全性比较：华法林组和利伐沙班组均未发生血栓栓塞事件（死亡、脑栓塞、肺栓塞、体循环栓塞）。两组均无大出血事件发生；不明显出血事件利伐沙班组为5％（3／57）、华法林组为11％（11／100），差异无统计学意义。结论口服利伐沙班用于血栓栓塞低、中危房颤患者导管消融术后抗凝安全有效。AIM To evaluate the effectiveness and safety of anticoagulant therapy with rivaroxaban in patients after radiofrequency catheter ablation （RFCA） of atrial fibrillation （AF）. METHODS A cohort of 157 patients who underwent RFCA for AF were enrolled. Patients were divided into rivaroxaban group （57 patients） and warfarin group （100 patients）. In rivaroxaban group, rivaroxaban （10 mg, bid or 20 mg, QD） was given for 1 month, and then 20 mg daily or l0 mg daily for 1 more month according to the patient＇ s CHADS2 score. In the warfarin group, standard medication of warfarin was given for 2 months by adjusting the INR in the range between 2.0 and 3.0. RESULTS No differences were observed in baseline characteristics between groups except for gender. For efficacy and safety, no differences were found between groups in the rates of death and thromboembolism events including cerebral, pulmonary and systemic emboli （0/57 cases in rivaroxaban group vs. 0/100 cases in warfarin group）. There were no TIMI major bleeding events in either group and no significant differences were seen in minor bleeding events between rivaroxaban group and warfarin group （3/57 cases vs. 11/100 cases）. CONCLUSION Compared with oral warfarin, the effectiveness and safety of oral rivaroxaban could be safely and effec- tively used in AF patients with low or medium risk of thromboembolism after RFCA.

关 键 词：心房颤动 导管消融术 抗凝治疗 利伐沙班 

分 类 号：R541.6[医药卫生—心血管疾病]