The Efficacy And Safety Of Dabigatrol In Elderly Patients With Non-valvular Atrial Fibrillation Complicated By Renal Insufficiency

ObjectivesTo evaluate the efficacy and security of dabigatran in aged patients with nonvalvular atrial fibrillation and renal insufficiency.Methods142 patients with nonvalvular atrial fibrillation over 80 years old combined with mild or moderate renal insufficiency were selected and divided into 3 groups: aspirin group(n=36)was treated with aspirin,warfarin group(n=38)was treated with warfarin,and dabigatinide group(n=68)was treated with dabigatinide.Patients in the dabigaturate group were divided into two subgroups,mild renal insufficiency(n=37)and moderate renal insufficiency(n=31).General data of the patients were recorded,and the changes in coagulation indexes,incidence of stroke and arterial thromboembolic events,bleeding events,and liver and kidney function indexes within 1 year were compared.ResultsPT and INR in warfarin group were statistically significant 1,3,6 and 12 months after treatment compared with that before treatment.TT and APTT at 1,3,6,12 months after darby group treatment were gradually extended,with statistical significance compared with that before treatment(P<0.05),and TT and APTT at 3,6,12 months after treatment were statistically significant compared with that at 1 month after treatment(P<0.05).The difference between warfarin group and dabiga group and aspirin group was statistically significant(P<0.05).In terms of the prevention of stroke and arterial embolism events,warfarin group and dabiga group were superior to baiaspirin group,with statistical significance P<0.05,but the difference between the two groups was notstatistically significant P>0.05.In terms of bleeding events,the incidence of minor bleeding was lower in the bayaspirin group than in the dabiga group and warfarin group,with statistical significance P<0.05.The incidence of severe bleeding was higher in warfarin group than in dabiga group and aspirin group,with statistical significance P<0.05.There was no statistical significance between the two subgroups of dabiga group,P>0.05.In terms of liver and kidney damage,there was no statistical significance between the three groups(P>0.05).Renal damage events in mild group were less than those in moderate group,with statistical significance P<0.05.ConclusionsIn the anticoagulant therapy of elderly patients with non-valvular atrial fibrillation combined with mild and moderate renal insufficiency,compared with aspirin and warfarin,dabigatrol has higher anticoagulant efficacy and better safety,which is suitable for clinical application.