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老年非瓣膜性心房颤动患者使用直接口服抗凝剂:实现个体化治疗。

Direct oral anticoagulants in non-valvular atrial fibrillation in elderly: for a treatment adapted to patient profile.

作者信息

Tayaa Saïd, Berrut Gilles, de Decker Laure, Chevalet Pascal

机构信息

Pôle de gérontologie clinique, Hôpital Bellier, CHU de Nantes, Nantes, France.

出版信息

Geriatr Psychol Neuropsychiatr Vieil. 2018 Sep 1;16(3):229-240. doi: 10.1684/pnv.2018.0746.

Abstract

Atrial fibrillation is the most frequent rhythm disorder in elderly patients. Moreover, the risk of stroke and the bleeding risk under anticoagulant treatment are the highest in this population. Vitamin K antagonists were until now the reference treatment of the anticoagulant treatment and they demonstrated a net benefit, including in elderly patients. The availability of the new oral anticoagulants, which do not require biological monitoring, simplified the anticoagulant treatment. However, data for the use of these molecules in elderly population remain limited. The benefit-risk ratio must not be assessed for this therapeutic class taken as a whole but for each molecule and according to the patient profile.

摘要

心房颤动是老年患者中最常见的节律紊乱。此外,该人群中风风险和抗凝治疗下的出血风险最高。迄今为止,维生素K拮抗剂一直是抗凝治疗的标准疗法,并且它们显示出净获益,包括在老年患者中。新型口服抗凝剂的出现,无需进行生物监测,简化了抗凝治疗。然而,这些药物在老年人群中的使用数据仍然有限。不能对这一治疗类别整体评估其获益风险比,而应针对每种药物并根据患者情况进行评估。

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