Department of Internal Medicine, Oslo University Hospital, Oslo, Norway.
JAMA. 2014 Mar 19;311(11):1150-1. doi: 10.1001/jama.2014.1403.
Is treatment with factor Xa inhibitors associated with better efficacy and safety compared with the vitamin K antagonist warfarin for preventing strokes or other systemic embolic events in patients with atrial fibrillation?
Compared with warfarin, factor Xa inhibitors are associated with a lower risk of stroke and other systemic embolic events in patients with atrial fibrillation. Factor Xa inhibitors were associated with lower rates of intracranial hemorrhage and mortality compared with warfarin. Factor Xa inhibitors were associated with a reduction in major bleeding events, but there was heterogeneity between the included studies, and the reduction was not statistically significant in a prespecified sensitivity analysis.
与维生素 K 拮抗剂华法林相比，使用 Xa 因子抑制剂治疗是否可提高疗效并改善安全性，从而预防房颤患者的中风或其他全身性栓塞事件？
与华法林相比，Xa 因子抑制剂可降低房颤患者的中风和其他全身性栓塞事件风险。Xa 因子抑制剂颅内出血发生率和死亡率低于华法林。Xa 因子抑制剂大出血事件发生率降低，但纳入的研究存在异质性，且预先设定的敏感性分析未显示该降低具有统计学意义。
