低剂量利伐沙班在非瓣膜性心房颤动合并心力衰竭的衰弱老老年患者应用

Abstract: Objective To evaluate the safety and efficacy of low-dose rivaroxaban in preventing stroke and systemic embolism in the frail oldest-old patients with non-valvular atrial fibrillation (NVAF) and heart failure. Methods 269 patients over 80 years old with NVAF and heart failure, including both frail and non-frail patients, were selected from two medical centers. The frail group (Group A) was randomly divided into two subgroups: Group A1 received rivaroxaban 10 mg (n＝50) and Group A2 received rivaroxaban 15 mg (n＝54). The non-frail group (Group B) received rivaroxaban 15 mg (n＝165). The anticoagulation effect, safety, and improvement in quality of life after treatment with low-dose rivaroxaban in the frail oldest-old patients were compared. Results The incidence of embolism events in Group A1, Group A2 and Group B was not significantly different (P＞0.05). The incidence of bleeding events in Group A1 and Group B was lower than that in Group A2 (P＜0.05). The incidence of adverse reactions in Group A1, Group A2 and Group B was not significantly different (P＞0.05). After treatment, the quality of life score in Group A1 was lower than that in Group A2 and Group B, and the score in Group A2 was lower than that in Group B (P＜0.05). The medication compliance in Group A1 and Group B was higher than that in Group A2 (P＜0.05). Conclusion Low-dose rivaroxaban has higher safety, lower incidence of adverse reactions, more significant improvement in quality of life, comparable incidence of embolism events, and better medication compliance in the frail oldest-old patients with NVAF and heart failure, indicating that it has more advantages in clinical efficacy.