艾多沙班在超高龄心房颤动患者中的有效性及安全性分析

Analysis of efficacy and safety of edoxaban in very elderly patients with atrial fibrillation

中文关键词: 心房颤动  超高龄  艾多沙班  利伐沙班  出血

英文关键词: atrial fibrillation  very elderly  edoxaban  rivaroxaban  bleeding

中文摘要:

      目的 分析艾多沙班对超高龄心房颤动(AF)患者的有效性、安全性及出血事件的影响因素.方法 回顾性分析2023年7月—2025年1月≥85岁AF患者448例,其中艾多沙班组212例,利伐沙班组236例.收集2组的临床资料,随访6个月后记录患者用药期间的有效性终点和安全性终点及其他不良反应.多因素Logistic回归法探讨艾多沙班组患者出现出血事件的影响因素.结果 2组有效性终点事件发生率差异无统计学意义(2.36％比2.53％,P＞0.05).与利伐沙班组相比,艾多沙班组出血患者构成比较少,差异有统计学意义(10.59％比5.19％,P＜0.05).与未出血组相比,出血组体质量较轻,体质量指数(BMI)较低,HAS-BLED评分较高,差异有统计学意义(P＜0.05).多因素Logistic回归分析显示,HAS-BLED评分高和联合抗血小板药物是艾多沙班组发生出血事件的独立风险因素,较高的BMI是出血事件的保护因素.结论 艾多沙班在超高龄AF患者中的有效性与利伐沙班无明显差异,且艾多沙班安全性更优.艾多沙班联合抗血小板药物、较高的HAS-BLED评分、低BMI可增加超高龄AF患者的出血风险.

英文摘要:

      Objective To analyze the efficacy and safety of edoxaban in very elderly patients with atrial fibrillation(AF)and the influence factors of bleeding events.Methods A retrospective analysis was conducted on 448 AF patients aged≥85 years treated between July 2023 and January 2025,including 212 cases in the edoxaban group and 236 cases in the rivaroxaban group.The clinical data of the two groups were collected.After a 6-month follow-up,the efficacy endpoints,safety endpoints and other adverse reactions of the patients during the medication period were recorded.Multivariate Logistic regression was used to identify factors influencing bleeding events in the edoxaban group.Results There was no statistically significant difference in the incidence of efficacy endpoint events between the two groups(2.36％vs 2.53％,P＞0.05).The proportion of patients experiencing bleeding events in the edoxaban group was significantly lower than that in the rivaroxaban group(5.19％vs 10.59％,P＜0.05).Compared with the non-bleeding group,patients in the bleeding group had significantly lower body weight,lower body mass index(BMI),and higher HAS-BLED scores,all with statistically significant differences(P＜0.05).Multivariate Logistic regression analysis showed that high HAS-BLED score and concomitant antiplatelet drug use were independent risk factors for bleeding in the edoxaban group,while a higher BMI was a protective factor.Conclusion The efficacy of edoxaban in very elderly AF patients shows no significant difference from that of rivaroxaban,and edoxaban has better safety.Concomitant antiplatelet therapy,higher HAS-BLED scores,and lower BMI may increase the risk of bleeding in very elderly AF patients treated with edoxaban.