The Effectiveness And Safety Evaluation Of Non-vitamin Kantagonist Oral Anticoagulants (NOACs) In Senile Patients With Non-valvular Atrial Fibrillation

Objective:Evaluate the effectiveness and safety of non-vitamin K antagonist oral anticoagulants(NOACs)medicated in senile patients with non-valvular atrial fibrillation,to guide the clinical medication.Methods:150 patients(aged?80)with non-valvular atrial fibrillation from Cardiology,4th ward during june 2014 to june 2016 were enrolled.50 patients received warfarin,make their international normalized ratio(INR)2.0-2.5,50 patients received dabigatran etexilate 110 mg,orally twice a day.50 patients received rivaroxaban 10 mg,orally once a day.To Compare the three groups of the incidence of thromboembolic events and bleeding events.Before treatment,after treatment(3 days,1 months,3 months and 6 months),hemoglobin,liver and kidney function,blood coagulation function were observed.Results:1.The incidence of thromboembolic events have no differences btween the three groups.The incidence of bleeding events have no difference btween dabigatran etexilate group and rivaroxaban group,compared with the warfarin group,the incidence of bleeding events in dabigatran etexilate group and rivaroxaban group is lower,and the reductions was statistically significant(P<0.05).2.The results who was received dabigatran etexilate is that compared with the pretreatment,there was no significant difference in hemoglobin,liver and kidney function after treatment(P > 0.05).Activated partial thromboplastin time(APTT)were prolonged in 3 days,the extention was statistically significant(P<0.05),after treatment(3 days,1 months,3months,6 moths),activated partial thromboplastin time(APTT)had a tendency to increase,but the increment was not statistically significant(P>0.05),but no more than twice of the upper limit value.The results who was received rivaroxaban is that compared with the pretreatment,there was no significant difference in hemoglobin,liver and kidney function after treatment(P>0.05).Prothrombin time(PT)were prolonged in 3 days,the extention was statistically significant(P<0.05),after treatment(3 days,1 months,3months,6 moths),prothrombin time(PT)had a tendency to increase,but the increment was not statistically significant(P>0.05),but no more than twice of the upper limit value.Conclusions:1.Senile patients with non valvular atrial fibrillation patients take non-vitamin K antagonist oral anticoagulants(NOACs)were effective,more safer than warfarin.2.There is no need to monitor the blood coagulation function,but in senile patients,suspect high bleeding risk,and slight bleeding,we can monitor activated partial thromboplastin time(APTT)in dabigatran etexilate group and prothrombin time(PT)in rivaroxaban group,when the the numerical no more than twice of the upper limit value,we consider it is safe,and we need to monitor kidney function and calculate Ccr before take non-vitamin K antagonist oral anticoagulants(NOACs).The sample size is small,and there should be more observation time.We need to increase the sample size and the observation time.