一项 RIVA-DM 亚组分析调查了年龄在 80 岁以下和 80 岁以上的非瓣膜性心房颤动和 2 型糖尿病患者。
A RIVA-DM Subanalysis Investigating Patients With Nonvalvular Atrial Fibrillation and Type 2 Diabetes Aged Under Versus Over 80 Years.
机构信息
School of Pharmacy, 7712University of Connecticut, Storrs, CT, USA.
Evidence-Based Practice Center, 23893Hartford Hospital, Hartford, CT, USA.
出版信息
Clin Appl Thromb Hemost. 2022 Jan-Dec;28:10760296221133083. doi: 10.1177/10760296221133083.
BACKGROUND
Advanced age and type 2 diabetes (T2D) are common in patients with nonvalvular atrial fibrillation (NVAF). We evaluated the impact of age on the effectiveness and safety of rivaroxaban versus warfarin in this population.
METHODS
We analyzed electronic health record data from November 2010, to December 2019 including adults with NVAF and T2D, newly started on rivaroxaban or warfarin. Propensity score-overlap weighted hazard ratios (HRs) for stroke/systemic embolism (SSE), hospitalization for major or clinically relevant nonmajor bleeding (CRNMB), vascular death, major adverse limb events (MALE), major bleeding, and intracranial hemorrhage (ICH) were calculated for older (≥80 years) and younger (<80 years) cohorts.
RESULTS
We included 32 078 rivaroxaban and 83 971 warfarin users (6606 rivaroxaban and 25,335 warfarin patients were aged ≥80 years). No significant interaction for rivaroxaban versus warfarin by age was observed for any outcome, including SSE (HR = 1.05 vs 0.95), hospitalization for major or CRNMB (HR = 1.06 vs 0.90), vascular death (HR = 0.92 vs 0.90), MALE (HR = 0.80 vs 0.76), major bleeding or ICH.
CONCLUSIONS
The effectiveness and safety of rivaroxaban versus warfarin remained consistent across patient age subgroups.
背景
高龄和 2 型糖尿病（T2D）在非瓣膜性心房颤动（NVAF）患者中较为常见。我们评估了年龄对该人群中利伐沙班与华法林有效性和安全性的影响。
方法
我们分析了 2010 年 11 月至 2019 年 12 月的电子健康记录数据，包括新开始接受利伐沙班或华法林治疗的 NVAF 和 T2D 成年患者。计算了年龄≥80 岁和年龄<80 岁的患者中风/全身性栓塞（SSE）、大出血或临床相关非大出血住院（CRNMB）、血管性死亡、主要不良肢体事件（MALE）、大出血和颅内出血（ICH）的利伐沙班与华法林的倾向评分重叠加权风险比（HR）。
结果
我们纳入了 32078 名利伐沙班和 83971 名华法林使用者（6606 名利伐沙班和 25335 名华法林患者年龄≥80 岁）。在任何结局中，利伐沙班与华法林的治疗效果并未因年龄而出现显著差异，包括 SSE（HR=1.05 vs. 0.95）、大出血或 CRNMB 住院（HR=1.06 vs. 0.90）、血管性死亡（HR=0.92 vs. 0.90）、MALE（HR=0.80 vs. 0.76）、大出血或 ICH。
结论
利伐沙班与华法林的有效性和安全性在患者年龄亚组中保持一致。
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