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降低强度的利伐沙班用于预防复发性静脉血栓栓塞
Reduced-Intensity Rivaroxaban for the Prevention of Recurrent Venous Thromboembolism


Mark A. Crowther ... 心脑血管疾病 呼吸系统疾病 • 2017.03.30
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• 口服直接抗凝剂与使用华法林治疗静脉血栓栓塞的安全性比较 • 利伐沙班和阿司匹林在预防复发性静脉血栓栓塞方面的比较 • 利伐沙班或阿司匹林用于静脉血栓栓塞延长治疗的研究

华法林和口服直接抗凝剂可预防复发性静脉血栓栓塞。当静脉血栓栓塞的首次发作与一过性危险因素(如手术)相关时,治疗可在3个月后停止。而当有持续且较高的危险因素,如癌症时,治疗应该无限期持续1。目前,对大多数无诱因的静脉血栓栓塞患者推荐进行长期抗凝治疗。而在被判断为有低复发危险的一些女性患者中2,在伴有高出血危险的患者中,以及在依从性较差或厌恶抗凝治疗的患者中,可以建议在3~6个月后停止治疗。





作者信息

Mark A. Crowther, M.D., and Adam Cuker, M.D.
From the Departments of Pathology and Molecular Medicine, Medicine, and Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada (M.A.C.); and the Departments of Medicine and Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia (A.C.).

 

参考文献

1. Kearon C, Akl EA, Ornelas J, et al. Antithrombotic therapy for VTE disease: CHEST guideline and expert panel report. Chest 2016;149:315-352

2. Rodger MA, Scarvelis D, Kahn SR, et al. Long-term risk of venous thrombosis after stopping anticoagulants for a first unprovoked event: a multi-national cohort. Thromb Res 2016;143:152-158

3. Kearon C, Ginsberg JS, Kovacs MJ, et al. Comparison of low-intensity warfarin therapy with conventional-intensity warfarin therapy for long-term prevention of recurrent venous thromboembolism. N Engl J Med 2003;349:631-639

4. Ridker PM, Goldhaber SZ, Danielson E, et al. Long-term, low-intensity warfarin therapy for the prevention of recurrent venous thromboembolism. N Engl J Med 2003;348:1425-1434

5. Simes J, Becattini C, Agnelli G, et al. Aspirin for the prevention of recurrent venous thromboembolism: the INSPIRE collaboration. Circulation 2014;130:1062-1071

6. Chai-Adisaksopha C, Crowther M, Isayama T, Lim W. The impact of bleeding complications in patients receiving target-specific oral anticoagulants: a systematic review and meta-analysis. Blood 2014;124:2450-2458

7. Agnelli G, Buller HR, Cohen A, et al. Apixaban for extended treatment of venous thromboembolism. N Engl J Med 2013;368:699-708

8. Weitz JI, Lensing AWA, Prins MH, et al. Rivaroxaban or aspirin for extended treatment of venous thromboembolism. N Engl J Med 2017;376:1211-1222

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