Section of Pulmonary and Critical Care Medicine, Department of Medicine, West Virginia University, USA.
Department of Surgery, NYU Langone Health, NYU Long Island School of Medicine, New York, USA.
Pulm Med. 2021 Nov 25;2021:3432362. doi: 10.1155/2021/3432362. eCollection 2021.
We studied the safety and efficacy of warfarin compared to direct acting oral anticoagulant use in patients with IPF.
We conducted a retrospective cohort study of all patients with IPF who were prescribed warfarin or direct acting oral anticoagulants (DOACs) for cardiac or thromboembolic indications and followed at our institute for their care. Univariate tests and multivariable logistic regression analyses were used for assessing association of variables with outcomes.
A total of 73 patients were included in the study with 28 and 45 patients in the warfarin and DOAC groups, respectively. Univariable analysis revealed a significant difference in mortality in one year between warfarin and DOAC groups (7/28 vs. 3/45, value 0.027). Significantly more patients in the warfarin group suffered an exacerbation that required hospitalization within one year (9/28 vs. 5/45, value 0.026). Multivariate logistic regression analysis showed that anticoagulation with warfarin was independently associated with mortality at one-year follow-up (OR: 77.4, 95% CI: 5.94-409.3, value: 0.007).
In our study of patients with IPF requiring anticoagulants, we noted statistically significant higher mortality with warfarin anticoagulation when compared to DOAC use. Further larger prospective studies are needed to confirm these findings.
我们研究了与直接作用口服抗凝剂相比，华法林在特发性肺纤维化（IPF）患者中的安全性和疗效。
我们对所有因心脏或血栓栓塞指征而接受华法林或直接作用口服抗凝剂（DOAC）治疗并在我院接受治疗的 IPF 患者进行了回顾性队列研究。采用单变量检验和多变量逻辑回归分析评估变量与结局的相关性。
本研究共纳入 73 例患者，华法林组和 DOAC 组分别有 28 例和 45 例。单变量分析显示，华法林组和 DOAC 组在一年内的死亡率存在显著差异（7/28 与 3/45， 值 0.027）。华法林组中有更多患者在一年内因病情加重需要住院治疗（9/28 与 5/45， 值 0.026）。多变量逻辑回归分析显示，华法林抗凝与一年随访时的死亡率独立相关（OR：77.4，95%CI：5.94-409.3， 值：0.007）。
在我们对需要抗凝治疗的 IPF 患者的研究中，与 DOAC 相比，华法林抗凝治疗的死亡率明显更高。需要进一步进行更大规模的前瞻性研究来证实这些发现。
