Résumé
Objective To investigate the effectiveness and safety of low-intensity warfarin anticoagulation in over 80-year-old patients with nonvascular atrial fibrillation (NVAF). Methods The 180 NVAF patients aged over 80 years were randomly assigned into 2 groups: 90 patients in lowintensity warfarin anticoagulation group (target value of INR 1.6-2.0), the other 90 patients in standard-intensity warfarin anticoagulation group (target value of INR 2. 0-3.0). All patients were followed up in outpatient-department for one year. Main outcome measures included the incidence rates of bleeding and thromboembolic events, and secondary outcome measures included the warfarin dosage and times of INR＞3.0. Results The incidence rate of thromboembolic events was 4.4% (4/90) in low-intensity group and 3.3% (3/90) in standard-intensity group with no statistically significant difference between these two groups (P＞0. 05). However, the incidence rate of hemorrhage was significantly lower in low-intensity group than in standard-intensity group [5.6% (5/90) vs. 16.7%(15/90), P＜0. 05]. Meanwhile the warfarin dosage was significantly lower in low-intensity group than in standard-intensity group [(1. 55±0. 63) mg vs. (2.31±0.57) mg, P＜0.05]. The times of INR＞3.0 were less in low-intensity group than in standard-intensity group (P＜0. 05). Conclusions Therapy with low-intensity warfarin anticoagulation in NVAF patients aged over 80 years may be equally effective as, but safer than that with standard-intensity warfarin.
Résumé
<p><b>OBJECTIVE</b>To investigate whether coagulation factor VII (FVII) polymorphisms play a role in the pathogenesis of coronary artery disease (CAD) and/or myocardial infarction (MI) in a series of Hans.</p><p><b>METHODS</b>The Arg(353)Gln and HVR4 polymorphisms of FVII gene were determined in 374 patients undergoing selective coronary angiography by PCR and restriction fragment length polymorphism assay.</p><p><b>RESULTS</b>The FVII genotype distribution was in accordance with Hardy-Weinberg equilibrium. The frequencies of FVII genotypes or alleles did not show significant differences between the CAD group and the controls or between the males and the females. The frequencies of carriers of the Gln(353) allele and (Arg/Gln + Gln/Gln) genotypes were significantly higher in the CAD patients without MI than in those with MI (P = 0.031, odds ratio 0.37, 95% CI: 0.15 - 0.94). However, HVR4 polymorphisms were not significantly different between the two groups (P > 0.05).</p><p><b>CONCLUSION</b>Carrying the F VII Gln(353) gene may be a protective factor against MI in the Chinese Hans.</p>