Association of Low Body Weight with Clinical Outcomes in Elderly Atrial Fibrillation Patients Receiving Apixaban?J-ELD AF Registry Subanalysis
Association of Low Body Weight with Clinical Outcomes in Elderly Atrial Fibrillation Patients Receiving Apixaban?J-ELD AF Registry Subanalysis
复制标题
接受阿哌沙班治疗的老年房颤患者低体重与临床结果的关系？J-ELD AF 登记亚分析
DOI：
10.1007/s10557-021-07180-4
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发表时间：
2021
影响因子：
3.4
通讯作者：
Okumura Ken
中科院分区：
文献类型：
--
作者：
Kadosaka Takahide;on behalf of the J-ELD AF investigators;Nagai Toshiyuki;Suzuki Shinya;Sakuma Ichiro;Akao Masaharu;Yamashita Takeshi;Anzai Toshihisa;Okumura Ken
虽然直接口服抗凝剂对低体重房颤（AF）患者预防卒中是有效和安全的，但在极低体重（<50 kg）AF患者中的数据仍然有限。我们的目的是调查这一体重类别与老年AF患者接受apixaban.MethodsThe AF登记处的临床结局的关联，是一个大规模的，多中心的前瞻性观察性研究，日本非瓣膜性AF患者年龄≥ 75岁，服用标签剂量的阿哌沙班。整个队列（来自110家机构的3025例患者）分为3个体重亚组：>60公斤（n= 1019，33.7%），50-60 kg（n= 1126，37.2%），且<50 kg 880例，占29.1%。（/100人年）分别为1.69、1.82和1.23（P= 0.60）;需要住院治疗的出血为1.37、1.73和2.73（P= 0.154）;总死亡分别为2.02、2.67和4.92（P= 0.003）;心血管死亡分别为0.73、0.95和1.23（P= 0.57）。通过考克斯回归分析校正混杂因素后，体重<50 kg不是卒中或全身性栓塞、需要住院治疗的出血、总死亡或心血管死亡的独立风险。在年龄≥ 75岁的日本非瓣膜性AF患者中，体重<50 kg可能不是使用标签剂量阿哌沙班的独立死亡风险。
PurposeAlthough direct oral anticoagulants are effective and safe in preventing stroke in atrial fibrillation (AF) patients with low body weight, data remain limited in AF patients with extremely low body weight (<50 kg). We aimed to investigate the association of this body weight category with clinical outcomes in elderly AF patients receiving apixaban.MethodsThe J-ELD AF Registry is a large-scale, multicenter prospective observational study of Japanese non-valvular AF patients aged ≥ 75 years taking on-label doses of apixaban. The entire cohort (3025 patients from 110 institutions) was divided into three body weight subgroups: >60 kg (n= 1019, 33.7%), 50–60 kg (n= 1126, 37.2%), and <50 kg (n= 880, 29.1%).ResultsThe event incidence rates (/100 person years) were 1.69, 1.82, and 1.23 for stroke or systemic embolism (P= 0.60); 1.37, 1.73, and 2.73 for bleeding requiring hospitalization (P= 0.154); 2.02, 2.67, and 4.92 for total death (P= 0.003); and 0.73, 0.95, and 1.23 for cardiovascular death (P= 0.57), respectively. After adjusting for confounders by Cox regression analysis, body weight <50 kg was not an independent risk for stroke or systemic embolism, bleeding requiring hospitalization, total death, or cardiovascular death.ConclusionsThe incidence of events in each body weight group was comparable for stroke or systemic embolism and bleeding requiring hospitalization, and body weight <50 kg might not be an independent risk for death in Japanese non-valvular AF patients aged ≥ 75 years taking on-label doses of apixaban.