Penn State College of Medicine, Hershey, PA 17033, USA.
Department of Internal Medicine, Penn State Health Milton S Hershey Medical Center, Hershey, PA 17033, USA.
Future Cardiol. 2022 Sep;18(10):829-837. doi: 10.2217/fca-2021-0146. Epub 2022 Sep 2.
Obesity is an epidemic with rising prevalence, and obese patients are predisposed to comorbid conditions that increase risk for thromboembolic events. It is critical to identify safe and effective anticoagulation therapy for use in this population. Direct oral anticoagulants (DOACs) are a preferred option for anticoagulation in patients of normal weight due to many benefits and equivalent safety and efficacy to their vitamin K antagonist counterparts. However, the safety and efficacy of DOACs in obese patients is not well understood. This review describes recent studies on the pharmacokinetics, safety and efficacy, and clinical outcomes of the DOACs apixaban, rivaroxaban, edoxaban and dabigatran in obese patient populations. DOACs may be a beneficial alternative to vitamin K antagonist therapy in obese patient populations.
肥胖是一种流行疾病，其发病率不断上升，肥胖患者易患合并症，增加血栓栓塞事件的风险。对于这类人群，确定安全有效的抗凝治疗方法至关重要。直接口服抗凝剂（DOACs）由于具有许多益处，且在安全性和有效性方面与维生素 K 拮抗剂相当，因此是正常体重患者抗凝治疗的首选。然而，肥胖患者使用 DOACs 的安全性和有效性尚不清楚。本文综述了最近关于 DOACs（阿哌沙班、利伐沙班、依度沙班和达比加群）在肥胖患者人群中的药代动力学、安全性和有效性以及临床结局的研究。DOACs 可能是肥胖患者群体替代维生素 K 拮抗剂治疗的有益选择。
