PDF(Pubmed)
Abstract：
BACKGROUND: New-onset postoperative atrial fibrillation (POAF) is a common complication after coronary artery bypass grafting (CABG) surgery, increasing the risk of embolism and stroke. There is a lack of information on the use of anticoagulants in this context. The choice between Warfarin and Direct oral anticoagulants (DOACs) also is not well-established. This randomized study aimed to compare the feasibility and safety of Warfarin and Rivaroxaban in preventing thrombotic events in POAF patients after isolated CABG.
METHODS: A total of 66 patients were randomized parallelly with 1:1 allocation to receive either Rivaroxaban (n = 34) or Warfarin (n = 32). Major bleeding events within 30 days after discharge were the primary outcome. Secondary outcomes included minor bleeding events and thrombotic episodes. Clinical characteristics, medication regimens, and left atrial diameter were assessed. Statistical analyses were performed using appropriate tests.
RESULTS: No thrombotic episodes were observed in either treatment arm. No major bleeding events occurred in either group. Four minor bleeding events were reported, with no significant difference between the treatment groups (P = 0.6). Patients with atrial fibrillation had significantly larger left atrial diameters compared to those with normal sinus rhythm (40.5 vs. 37.8 mm, P = 0.01).
CONCLUSIONS: This pilot study suggests that Warfarin and Rivaroxaban are both safe and effective for preventing thrombotic episodes in POAF patients after isolated CABG. No significant differences in major bleeding events were observed between the two anticoagulants. These findings may support the preference for DOACs like Rivaroxaban due to their convenience and easier maintenance.
BACKGROUND: Number IRCT20200304046696N1, Date 18/03/2020 https//irct.behdasht.gov.ir/ .
METHODS: A total of 66 patients were randomized parallelly with 1:1 allocation to receive either Rivaroxaban (n = 34) or Warfarin (n = 32). Major bleeding events within 30 days after discharge were the primary outcome. Secondary outcomes included minor bleeding events and thrombotic episodes. Clinical characteristics, medication regimens, and left atrial diameter were assessed. Statistical analyses were performed using appropriate tests.
RESULTS: No thrombotic episodes were observed in either treatment arm. No major bleeding events occurred in either group. Four minor bleeding events were reported, with no significant difference between the treatment groups (P = 0.6). Patients with atrial fibrillation had significantly larger left atrial diameters compared to those with normal sinus rhythm (40.5 vs. 37.8 mm, P = 0.01).
CONCLUSIONS: This pilot study suggests that Warfarin and Rivaroxaban are both safe and effective for preventing thrombotic episodes in POAF patients after isolated CABG. No significant differences in major bleeding events were observed between the two anticoagulants. These findings may support the preference for DOACs like Rivaroxaban due to their convenience and easier maintenance.
BACKGROUND: Number IRCT20200304046696N1, Date 18/03/2020 https//irct.behdasht.gov.ir/ .
摘要：
背景：新发术后心房颤动（POAF）是冠状动脉旁路移植术（CABG）手术后的常见并发症，增加栓塞和中风的风险。在这种情况下，缺乏有关使用抗凝剂的信息。华法林和直接口服抗凝剂（DOAC）之间的选择也不是很确定。这项随机研究旨在比较华法林和利伐沙班在预防POAF患者单纯性CABG后血栓事件的可行性和安全性。
方法：共66例患者以1：1的比例随机分配，分别接受利伐沙班（n=34）或华法林（n=32）。出院后30天内的主要出血事件是主要结果。次要结果包括轻微出血事件和血栓事件。临床特征,药物治疗方案,评估左心房直径。使用适当的测试进行统计分析。
结果：在任一治疗组中均未观察到血栓发作。两组均无大出血事件发生。报告了4次轻微出血事件，治疗组之间无显著差异(P=0.6)。与正常窦性心律患者相比，房颤患者的左心房直径明显更大（40.5vs.37.8mm,P=0.01）。
结论：这项初步研究表明，华法林和利伐沙班对于预防单纯CABG后POAF患者的血栓发作既安全又有效。两种抗凝剂在严重出血事件方面没有观察到显著差异。这些发现可能支持对利伐沙班等DOAC的偏爱，因为它们方便且易于维护。
背景：编号IRCT20200304046696N1，日期18/03/2020https///irct。behdash.govir/.
方法：共66例患者以1：1的比例随机分配，分别接受利伐沙班（n=34）或华法林（n=32）。出院后30天内的主要出血事件是主要结果。次要结果包括轻微出血事件和血栓事件。临床特征,药物治疗方案,评估左心房直径。使用适当的测试进行统计分析。
结果：在任一治疗组中均未观察到血栓发作。两组均无大出血事件发生。报告了4次轻微出血事件，治疗组之间无显著差异(P=0.6)。与正常窦性心律患者相比，房颤患者的左心房直径明显更大（40.5vs.37.8mm,P=0.01）。
结论：这项初步研究表明，华法林和利伐沙班对于预防单纯CABG后POAF患者的血栓发作既安全又有效。两种抗凝剂在严重出血事件方面没有观察到显著差异。这些发现可能支持对利伐沙班等DOAC的偏爱，因为它们方便且易于维护。
背景：编号IRCT20200304046696N1，日期18/03/2020https///irct。behdash.govir/.
