Division of Cardiology, Department of Medicine, University of New Mexico, Albuquerque, NM.
Los Angeles Biomedical Research Center, Harbor-UCLA Medical Center, Torrance, CA.
Am Heart J. 2019 Jun;212:129-133. doi: 10.1016/j.ahj.2019.02.014. Epub 2019 Mar 13.
Warfarin has been showed to increase vascular calcification. Apixaban, a direct factor Xa inhibitor, has no interaction with vitamin K and its effect on coronary plaques is unknown. We randomized and compared warfarin and apixaban on progression of coronary atherosclerotic plaques measured by coronary computed tomographic angiography in 66 subjects with non-valvular atrial fibrillation over the period of one-year follow up. There was significant higher total, calcified and low attenuation plaque volume in the group randomized to warfarin as compared to apixaban (all P < .05). Greater volume of total (β = 28.54; P = .03), low attenuation plaque (β = 3.58; P = .02) and calcified (β = 14.10; P = .005) plaque progression was observed in the VKA_group.
华法林已被证明可增加血管钙化。阿哌沙班是一种直接的 Xa 因子抑制剂，与维生素 K 无相互作用，其对冠状动脉斑块的影响尚不清楚。我们在 66 例非瓣膜性心房颤动患者中进行了一项随机对照研究，比较了华法林和阿哌沙班在一年随访期间通过冠状动脉计算机断层血管造影术测量的冠状动脉粥样硬化斑块进展情况。与阿哌沙班相比，随机分配到华法林组的患者总、钙化和低衰减斑块体积明显更高（均 P<0.05）。华法林组的总（β=28.54；P=0.03）、低衰减斑块（β=3.58；P=0.02）和钙化斑块（β=14.10；P=0.005）的进展体积更大。
