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Jama: The first choice of anticoagulant drugs for elderly atrial fibrillation patients over 65 years -Grandhabane is better than Lidahabane in bleeding and ischemia.

According to statistics, the United States currently has 3 million atrial fibrillation patients, and by 2050, this number will reach 6 million-16 million. The stroke risk of patients with atrial fibrillation is 5 times that of the general population, and about 15%of the stroke is related to atrial fibrillation. Therefore, the anticoagulant therapy of atrial fibrillation patients is very necessary. Compared with vitamin K antagonists, direct oral anticoagulant drugs are mainly Lidiazan and Ah Saaban. They have the characteristics of pharmacokinetic dynamics, reliable efficacy, and convenient use. Recently, researchers have compared the impact of Lizhabane and Ah Saaban on the bleeding and ischemia ending of patients with atrial fibrillation.

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This study is a review of medical insurance records of patients 65 and above. From January 2013 to November 2018, a total of 58,1451 atrial fibrillation patients were treated with Liavarban or Ah Sahaban. Among them 227,572 people in the Pausha team, 35,3879 in the Grandhasha team, were followed up for 4 years. The main endpoints of the study are ischemia (stroke/systemic embolism) and bleeding (bleeding in the brain/other intracranial hemorrhage/fatal craniotomy). The secondary end point is non -fatal skull outbestion and total mortality.

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The average age of patients was 77.0 years old, 291,966 (50.2%) women, and 134393 (23.1%) reduced the drug dose. Follow -up 474605 patient year (medium follow -up time 174 days). After the adjustment of the Rido Saudi team, the main end -of -end event rate was 16.1/1,000 years, while the Aya Sha team was 13.4/1,000 years (HR: 1.18). The main ischemic event (8.6 vs 7.6 /1000 people, HR: 1.12) and bleeding event (7.5 vs 5.9 /1000 people; HR: 1.26) are high, including fatal skulls, including the year of 7.5 vs 5.9 /1000 people; Outblowing (1.4 VS1.0 /1000 people; HR: 1.41). A non -fatal skull outbestion in patients who received Ledhabane (39.7 vs 18.5/1000 people; HR: 2.07), fatal ischemia/bleeding (4.5 vs3.3/1000 years; HR: 1.34) The risk of total death is higher. In the drug reduction group (27.4VS21.0 /1000 people; HR, 1.28) and the standard dosage group (13.2VS11.4 /1000 people; HR, 1.13) the risk of the main endpoint event of the Liva team.

The risk of ischemia and bleeding in Ah Cyan is lower than that of Liavarban

Studies believe that for patients with atrial fibrillation at the age of 65, the risk of the main ischemia or bleeding incident treated by Ah Cyan is lower than that of Liavarban. It is recommended to be the first choice for anticoagulant drugs for atrial fibrillation.

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