利伐沙班在高龄非瓣膜性心房颤动患者中的安全性评价

Safety evaluation of rivaroxaban in senile patients with nonvalvular atrial fibrillation

目的探讨高龄非瓣膜性心房颤动(房颤)患者口服利伐沙班的安全性。方法回顾性分析2018年1月—2019年3月,复旦大学附属静安区中心医院心内科门诊或病房≥60岁口服利伐沙班的非瓣膜性房颤患者相关资料,根据患者的年龄分为≥80岁高龄组(n=104)和<80岁低龄组(n=56)。随访患者出血等并发症临床情况。结果160例患者年龄61~95岁,平均年龄(80.2±7.0)岁,CHA2DS2-VASc评分中位数为4,HAS-BLED评分中位数为1。所有患者服用利伐沙班的中位剂量为10 mg/d,其中36例(22.50%)剂量为15 mg/d,118例(73.75%)剂量为10 mg/d。高龄组应用利伐沙班10 mg/d多于低龄组(78.85%vs 64.29%,P=0.046)。中位随访时间7个月,2组出血并发症发生率差异无统计学意义(P=0.298)。结论80岁以上老年非瓣膜性房颤患者利伐沙班服用剂量多为10 mg/d,出血并发症和低龄老人组相似。

Objective To investigate the safety of rivaroxaban in senile patients with nonvalvular atrial fibrillation(AF).Methods The data of patients with nonvalvular AF who were over 60 years old and took rivaroxaban orally in Outpatient Department or Ward of Department of Cardiology,Central Hospital of Jing’An District from January 2018 to March 2019 was reviewed.According to the age of patients,they were divided into≥80 years old group(n=104)and<80 years old group(n=56).They were followed up for bleeding and other complications.Results 160 patients were 61 to 95 years old,with an average age of 80.2±7.0 years,the median of CHA2 DS2-VASc score was 4,and the median of HAS-BLED score was 1.The median dose of rivaroxaban was 10 mg/d in all patients,including 36 cases(22.50%)with 15 mg/d and 118 cases(73.75%)with 10 mg/d.Rivaroxaban 10 mg/d was more used in the≥80 years old group than in the<80 years old group(78.85%vs 64.29%,P=0.046).The median follow-up time was 7 months.There was no significant difference in the incidence of bleeding complications between the two groups(P=0.298).Conclusion The dose of rivaroxaban in senile patients(over 80 years old)with nonvalvular AF is mostly 10 mg/d,and the incidence of bleeding complications is similar to that of the younger elderly patients.