3/11 在漢神巨蛋聽了北榮江晨恩教授演講新一代口服抗凝血劑 Dabigatran 的分析:

整理如下

1.  Direct thrombin (factor IIa) inhibitor

2. 在 CHADS2 or CHA2DS2-VASc Score 大於或等於 2分的af患者, 不管是 Paroxysmal or permanent af, 給予OAC可以降低Stroke機率

3. Bleeding Risk 可用 HAS BLED Score來評估, 大於或等於 3分風險較高

4. The time in therapeutic range (TTR) 在 af 要控制在 65%以上，能減少STOKE

5. Dabagatran: according to Rely Study

   110 mg bid use,   superior to warfarin in Major bleeding rate, RRR 20%, p=0.003,

                               Prevention of hemorrhagic stroke, RRR 69%,  p<0.001

                               and Intracranial bleeding, RRR 69%,  p<0.001

                          

   150 mg bid use,   superior to warfarin in the prevention of stroke and systemic embolism, RRR 34%, p<0.001  ,

                                vascular mortality, RRR 15%,  p=0.04

                                Prevention of hemorrhagic stroke, RRR 74%,  p<0.001

                                and Intracranial bleeding, RRR 69%,  p<0.001