房颤吃阿哌沙班有用吗？

Apixaban is useful for atrial fibrillation. Atrial fibrillation (atrial fibrillation) can easily cause embolism, such as cerebral vascular embolism leading to stroke and other vascular embolism. Especially for stroke, anticoagulation treatment for atrial fibrillation is very important.

Apixaban is a new oral anticoagulant drug that can prevent and treat blood clots. Apixaban is an oral direct factor Xa inhibitor that can inhibit free and clot-bound factor Xa. It has been approved for clinical use in a variety of thromboembolic diseases, such as reducing the risk of stroke in non-valvular atrial fibrillation. It can effectively reduce thrombosis and thrombus shedding in the atrial wall, and prevent the occurrence of thromboembolic complications.

apixaban

It can inhibit thrombosis and can prevent and treat arterial and venous thrombosis, such as thromboprophylaxis after hip or knee replacement surgery, treatment of deep vein thrombosis or pulmonary embolism, and prevention of recurrent deep vein thrombosis and pulmonary embolism.

Apixaban's safety in treating atrial fibrillation

Study purpose: To evaluate the safety or effectiveness of apixaban in preventing stroke in hemodialysis patients with end-stage renal disease and atrial fibrillation.

Study Methods: The RENAL-AF trial (Renal Dialysis Patients Receiving Apixaban or Warfarin in Atrial Fibrillation) was a prospective, randomized, open-label, blinded outcome evaluation (PROBE) trial of apixaban or warfarin in patients with atrial fibrillation receiving hemodialysis.

154 patients were randomly assigned to receive apixaban at mg twice daily (n=82) or adjusted-dose warfarin (n=72).

Study results: Patients receiving warfarin spent 44% of the time in therapeutic range, and the 1-year incidence of major or clinically relevant non-major bleeding was 32% in the apixaban group and 26% in the warfarin group. The 1-year incidence of stroke or systemic embolism was 3.0% in the apixaban group and 3.3% in the warfarin group.

Other treatments for atrial fibrillation

1. Antiarrhythmic drugs: such as amiodarone, dofetilide, propafenone, sotalol, etc., can restore and maintain the patient's sinus rhythm.

2. Drugs to control ventricular rhythm: suitable for elderly patients, especially those with persistent atrial fibrillation, such as propranolol, bisoprolol, diltiazem, verapamil, digoxin, etc.

3. Surgical treatment: Commonly used surgical methods include radiofrequency ablation, left atrial isolation, corridor surgery, atrial transection, maze surgery, etc., which are suitable for patients with atrial fibrillation combined with other heart diseases who require surgical treatment.

4. Catheter ablation treatment: It is suitable for patients with atrial fibrillation accompanied by rapid ventricular rate and ineffective drug treatment. It has the advantages of minimally invasive, painless, fast recovery, and accurate curative effect.

References:

Pokorney SD, Chertow GM, Al-Khalidi HR, Gallup D, Dignacco P, Mussina K, Bansal N, Gadegbeku CA, Garcia DA, Garonzik S, Lopes RD, Mahaffey KW, Matsuda K, Middleton JP, Rymer JA, Sands GH, Thadhani R, Thomas KL, Washam JB, Winkelmayer WC, Granger CB; RENAL-AF Investigators. Apixaban for Patients With Atrial Fibrillation on Hemodialysis: A Multicenter Randomized Controlled Trial. Circulation. 2022 Dec 6;146(23):1735-1745. doi: 10.1161/CIRCULATIONAHA.121.054990. Epub 2022 Nov 6. PMID: 36335914.

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