Bando Shigenobu, Nishikado Akiyoshi, Hiura Norikazu, Ikeda Shuntaro, Kakutani Akiyoshi, Yamamoto Katsuhito, Kaname Noriyoshi, Fukatani Masahiko, Takagi Yuichiro, Yukiiri Kazushi, Fukuda Yamato, Nakaya Yutaka
Department of Arrhythmia, Kagawa Prefectural Shirotori Hospital, Kagawa, Japan.
Department of Cardiology, Uwajima City Hospital, Ehime, Japan.
J Cardiol. 2018 Feb;71(2):197-201. doi: 10.1016/j.jjcc.2017.08.005. Epub 2017 Sep 29.
The Shikoku Rivaroxaban Registry Trial (SRRT) is a retrospective survey of the use of rivaroxaban for stroke prevention in elderly patients in Shikoku, Japan.
The SRRT enrolled 1339 patients from 8 hospitals. Patients were divided into two groups according to their age, the extreme elderly group (453 patients aged ≧80 years) and the control group (886 patients aged <80 years).
In the extreme elderly group, 41.5% of the patients had low body weight (<50kg) and 65.1% had abnormal renal function (creatinine clearance <50ml/min). The mean CHADS, CHADS-VASc, and HAS BLED scores were 2.7, 4.4, and 2.3, respectively. There were 333 (73.5%) patients who met the dosing criteria, and of these patients, 81.2% received rivaroxaban 10mg daily. Thromboembolic events occurred in 4 patients (0.94%/person year) and intracranial hemorrhage occurred in 4 patients (0.89%/person year). The incidence of these events was not significantly different from the control group. In addition, all patients with cerebral infarction had been treated with a smaller dose of rivaroxaban than recommended by the dosing criteria, suggesting that dosing criteria should be adhered to.
These results suggest that rivaroxaban is effective and safe in extreme elderly patients with atrial fibrillation.
四国利伐沙班注册试验（SRRT）是一项对日本四国地区老年患者使用利伐沙班预防卒中情况的回顾性调查。
SRRT纳入了来自8家医院的1339例患者。根据年龄将患者分为两组，高龄组（453例年龄≧80岁的患者）和对照组（886例年龄<80岁的患者）。
在高龄组中，41.5%的患者体重较低（<50kg），65.1%的患者肾功能异常（肌酐清除率<50ml/分钟）。CHADS、CHADS-VASc和HAS BLED评分的平均值分别为2.7、4.4和2.3。有333例（73.5%）患者符合给药标准，在这些患者中，81.2%的患者每天接受10mg利伐沙班治疗。4例患者发生血栓栓塞事件（0.94%/人年），4例患者发生颅内出血（0.89%/人年）。这些事件的发生率与对照组无显著差异。此外，所有脑梗死患者接受的利伐沙班剂量均低于给药标准推荐剂量，提示应严格遵守给药标准。
这些结果表明，利伐沙班在高龄房颤患者中有效且安全。
