INR 控制质量与静脉血栓栓塞症的预后。
Quality of INR control and outcomes following venous thromboembolism.
机构信息
General Practice Research Database, Medicines and Healthcare products Regulatory Agency, London, UK.
出版信息
Clin Appl Thromb Hemost. 2012 Jul;18(4):370-8. doi: 10.1177/1076029611426139. Epub 2012 Jan 23.
INTRODUCTION
The objective of this study was to evaluate the pattern of anticoagulation after venous thromboembolism (VTE) in actual clinical practice.
MATERIAL AND METHODS
This study used the General Practice Research Database. Individuals aged 18+ years with VTE were matched to 3 controls.
RESULTS
Of the 46 335 patients with VTE and 138 024 controls, 70.2% of cases and 86.6% of controls had no obvious risk factors. The mortality risk was increased substantially around the time of diagnosis (relative hazard rate [RR] around 21) but remained elevated for a further 4 years (RRs around 1.5-2.0). The mean percentage of time spent within the therapeutic range for international normalized ratio (INR) was 57.0%. The lowest rate of VTE recurrence occurred in patients with ≥70% time spent within therapeutic range (RR of 0.50, 95% CI 0.39-0.63 compared to <30%).
CONCLUSIONS
Higher time spent within therapeutic INR range was associated with lower risks of VTE recurrence and death due to VTE.
简介
本研究旨在评估静脉血栓栓塞症（VTE）患者在实际临床实践中的抗凝模式。
材料与方法
本研究使用了全科医学研究数据库。年龄在 18 岁及以上的 VTE 患者与 3 名对照者相匹配。
结果
在 46335 例 VTE 患者和 138024 名对照者中，70.2%的病例和 86.6%的对照者无明显危险因素。在诊断时，死亡率显著增加（相对危险率[RR]约为 21），但在随后的 4 年内仍持续升高（RR 约为 1.5-2.0）。国际标准化比值（INR）治疗范围内的时间百分比平均为 57.0%。INR 治疗范围内时间比例≥70%的患者 VTE 复发率最低（RR 为 0.50，95%CI 0.39-0.63，与<30%相比）。
结论
INR 治疗范围内时间比例越高，VTE 复发和 VTE 相关死亡的风险越低。
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