维生素 K 拮抗剂与他汀类药物的药物相互作用：系统评价。
Drug-drug interactions between vitamin K antagonists and statins: a systematic review.
机构信息
Department of Clinical Biochemistry, Copenhagen University Hospital Hvidovre, Kettegaard Allé 30, 2650, Hvidovre, Denmark.
Department of Clinical Biochemistry and Pharmacology, Odense University Hospital, Odense, Denmark.
出版信息
Eur J Clin Pharmacol. 2021 Oct;77(10):1435-1441. doi: 10.1007/s00228-020-03074-w. Epub 2021 Apr 24.
PURPOSE
Concomitant use of vitamin K antagonists (VKA) and statins is frequent in cardiovascular patients. However, clinical guidelines on this drug combination are divergent. Therefore, we performed a systematic review to evaluate the effect of statin initiation on coagulation among VKA users.
METHODS
Following the PRISMA guidelines, we applied two broad search strategies for the drug interaction between VKA and statins in both Embase and Pubmed; 8623 unique hits were obtained. In the final sample, eight studies were included.
RESULTS
The most frequently used VKA in the studies was warfarin, while simvastatin was the most commonly initiated statin. All included studies showed a minor increase in the anticoagulant effect of VKA following statin initiation during VKA treatment. The reported increases in mean international normalized ratio (INR) ranged from 0.15-0.65.
CONCLUSION
The anticoagulant effect of statin initiation in patients treated with VKA is likely to be of limited clinical relevance but should be evaluated individually.
目的
心血管疾病患者常同时使用维生素 K 拮抗剂（VKA）和他汀类药物。然而，关于这种药物联合使用的临床指南存在差异。因此，我们进行了一项系统评价，以评估他汀类药物起始治疗对 VKA 使用者凝血的影响。
方法
根据 PRISMA 指南，我们在 Embase 和 Pubmed 中应用了两种广泛的搜索策略，以寻找 VKA 和他汀类药物之间的药物相互作用；共获得 8623 个独特的命中结果。在最终样本中，纳入了八项研究。
结果
研究中最常使用的 VKA 是华法林，而起始使用的最常见的他汀类药物是辛伐他汀。所有纳入的研究均表明，在 VKA 治疗期间起始他汀类药物治疗后，VKA 的抗凝作用略有增加。报告的平均国际标准化比值（INR）增加范围为 0.15-0.65。
结论
VKA 治疗患者起始他汀类药物治疗对凝血的影响可能具有有限的临床意义，但应个体化评估。
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