Pharmacy Services, 23506Sanford Health, Fargo, ND, USA.
12281University of North Dakota School of Medicine and Health Sciences, Grand Forks, ND, USA.
J Cardiovasc Pharmacol Ther. 2020 Nov;25(6):523-530. doi: 10.1177/1074248420929483. Epub 2020 Jun 1.
Direct-acting oral anticoagulants are indicated for the treatment of nonvalvular atrial fibrillation, but their use in patients after undergoing cardiac surgery is poorly defined despite a high prevalence of postoperative atrial fibrillation in this population.
Patients diagnosed with postoperative atrial fibrillation were prospectively randomized to warfarin or apixaban. Safety, efficacy, and economic outcomes were evaluated until their 4- to 6-week postoperative appointment.
While this pilot study was not powered to determine a difference in safety or efficacy, adverse event rates were similar to the published literature. It was noted that a patient's course of therapy when utilizing apixaban was significantly less costly than warfarin when including medication, bridging, and laboratory expenses.
Apixaban and warfarin both appeared to be safe and effective for anticoagulation throughout the duration of this pilot study in treating postoperative atrial fibrillation after coronary artery bypass grafting. Apixaban was associated with significantly less expense when bridging and monitoring costs were included in addition to medication expense.
直接作用的口服抗凝剂适用于治疗非瓣膜性心房颤动，但尽管该人群术后心房颤动的发生率很高，但其在心脏手术后患者中的应用仍未得到明确界定。
术后诊断为心房颤动的患者前瞻性随机分为华法林或阿哌沙班组。评估安全性、疗效和经济结果，直到他们术后 4 至 6 周的预约。
虽然这项试点研究没有足够的能力来确定安全性或疗效的差异，但不良事件发生率与已发表的文献相似。值得注意的是，在包括药物、桥接和实验室费用在内的情况下，使用阿哌沙班的患者的治疗过程明显比华法林更经济。
在这项治疗冠状动脉旁路移植术后术后心房颤动的试点研究中，阿哌沙班和华法林在整个研究期间似乎都是安全有效的。当包括桥接和监测成本以及药物成本在内时，阿哌沙班的费用明显更低。
