Clinical Efficacy Of Dabigatran Etexilate In Prevention Of Embolism And Adverse Events In Patients With Non Valvular Atrial Fibrillatio

Objective:Non valvular atrial fibrillation(NVAF)is a common arrhythmia in clinic.At present,there are about ten million patients with atrial fibrillation in China.With the aging of the population,the number of patients with atrial fibrillation will increase significantly in the future;the incidence of ischemic stroke in patients with non valvular atrial fibrillation is about 5%,which is 2-7 times that of non atrial fibrillation people.A large number of studies have confirmed that complications such as ischemic stroke and non central nervous system embolism are the primary risk of death and disability of atrial fibrillation.Prevention of new onset and recurrence of stroke is an important content of the comprehensive management of patients with atrial fibrillation.The rational use of anticoagulants can significantly reduce the incidence of ischemic stroke.At the present stage,our country is widely used in clinical practice.The oral anticoagulant Warfarin is effective in anticoagulation,but its treatment window is narrow,its speed is slow,the individual difference is large,the dose effect is not exact.The drug concentration is easily affected by food and other drugs.Although the price is moderate,it is necessary to monitor the INR value frequently and increase the economic burden and the quality of life of the patient is also affected.Many patients with high risk of stroke failed to fully accept Warfarin's anticoagulant therapy;secondly,the clinicians worried about the adverse events caused by Warfarin,so that Warfarin had considerable limitations in the actual use and limited the clinical application.Therefore,most patients with atrial fibrillation were unsatisfactory in anticoagulant therapy in China;ideal Oral anticoagulants not only can effectively prevent thrombosis,but also have less bleeding and other adverse events,and are safe and convenient to use.The new oral anticoagulant(novel oral anticoagulants,NOAC)uses a fixed dose,which is not easy to interact with other factors,and is more convenient to use,and does not need frequent laboratory monitoring.So we study the clinical observation of the new oral anticoagulant Dabi group ester(Dabigatran Etexilate)in the prevention of embolism and bleeding in non valvular atrial fibrillation(NVAF),and analyze the efficacy and safety of dabiga group ester in the prevention and embolization of non valvular atrial fibrillation.Methods:There are 98 patients with non valvular atrial fibrillation collected in the Department of Cardiology of our department of cardiology from October 2015 to October 2017 were selected as 98 cases of non valvular atrial fibrillation,53 male with an average age of(66.19±11.65)years of age.29 cases of dabagate group 150mg(DE 150mg),33 dababagate group(DE110mg),and warfarin foranticoagulant atrial fibrillation were randomly assigned.36 patients.The patients were followed up for 6 months,including drug maintenance dose,INR control range,followed up during the observation period and the occurrence of hemorrhage related events.Finally,we compared the incidence of embolic events and bleeding events between the three groups,so as to assess the benefits and risks of different drugs and different doses.Results:In group DE 110mg and Warfarin group,there were both cerebral apoplexy and non central nervous system Embolism Events(12.1%VS 11.1%P>0.05).There was no statistically significant difference in hemorrhagic events compared with Warfarin(6.1%VS 16.7%P<0,05).The difference was statistically significant.Compared with the Warfarin group,the cerebral apoplexy was compared with that of the Warfarin group.There were statistically significant differences in central nervous system Embolism Events(3.4%VS 11.1%P<0,05),bleeding events(20.6%VS 16.7%P>0,05),the difference was not statistically significant,and there was significant difference between the DE 150mg group and the DE 110mg group in the stroke and non central nervous system Embolism Events(3.4%VS 12.1%P<0,05).The incidence of adverse events in group A was higher than that in group DE110mg(20.7%VS6.1%P<0,05),and the difference was statistically significant.Conclusion(s):1.the effectiveness of prevention of embolic events:the clinical efficacy of DE 110mg in preventing stroke and non central nervous system embolism in patients with non valvular atrial fibrillation is similar to that of Warfarin.The clinical efficacy of DE150mg in preventing stroke and non central nervous system embolism in patients with non valvular atrial fibrillation is better than Warfarin;2.Safety evaluation:DE110mg is smaller and safer than DE150mg and Warfarin anticoagulant,and the probability of DE150mg and Warfarin is basically consistent with the probability of bleeding events,and the safety is similar.