Video Experimental Relacionado

Updated: Jan 31, 2026

Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation

Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation

Published on: February 26, 2013

Las tasas de hemorragia mayor en pacientes con fibrilación auricular en terapia antitrombótica única, doble o triple

Nienke van Rein^1,2,3, Uffe Heide-Jørgensen³, Willem M Lijfering^1,2,4

¹Department of Thrombosis and Hemostasis, Leiden University Medical Center, The Netherlands (N.v.R., W.M.L.).

|December 28, 2018

Resumen

La terapia triple para la fibrilación auricular aumenta significativamente el riesgo de hemorragia mayor, especialmente en pacientes de edad avanzada o con puntuaciones altas de CHA2DS2- VASc. La consideración cuidadosa de la terapia antitrombótica triple está justificada en estos grupos de alto riesgo.

Área de la Ciencia:

Cardiología
Farmacología
Salud pública

Sus antecedentes:

El tratamiento de la fibrilación auricular (FA) a menudo implica anticoagulantes y agentes antiplaquetarios.
Los datos sobre los riesgos de hemorragia con la terapia antitrombótica combinada en pacientes con FA de alto riesgo son limitados.

Objetivo del estudio:

Evaluar las tasas de hemorragia mayor en pacientes de FA de edad avanzada (≥50 años) con diferentes estrategias de tratamiento antitrombótico.
Para comparar los riesgos de sangrado asociados con la monoterapia, la terapia dual y la terapia triple.

Principales métodos:

Estudio de cohorte a nivel nacional de pacientes daneses con FA utilizando datos de prescripción.
Se estimaron las tasas de incidencia (IR) y los ratios de riesgo (HR) de hemorragias importantes.
Análisis estratificados por modalidad de tratamiento, edad, puntuación CHA2DS2-VASc y comorbilidades.

Principales resultados:

La terapia triple demostró tasas de sangrado mayor significativamente más altas en comparación con la monoterapia o la terapia dual.
Los pacientes en tratamiento triple con edades > 90 años o con puntuación CHA2DS2- VASc > 6 tuvieron tasas de hemorragia muy altas (17.6-22.8/ 100 AY).
El tratamiento triple con antagonista de vitamina K mostró un HR de 3,73 y el tratamiento triple con anticoagulantes orales directos mostró un HR de 2,28 para la hemorragia mayor frente a la monoterapia con VKA.

Conclusiones:

La triple terapia antitrombótica en pacientes con FA está asociada con un aumento sustancial del riesgo de hemorragia mayor.
Las tasas altas de hemorragia en pacientes ancianos (> 90 años), aquellos con puntuaciones altas de CHA2DS2- VASc (> 6) o antecedentes de hemorragia requieren el uso cauteloso de la terapia triple.

Palabras clave:

Agentes anticoagulantes Fibrilación auricular Estudios de cohorte hemorragia en el cuerpo Inhibidores de la agregación plaquetaria

Más Videos Relacionados

The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation

The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation

Published on: February 28, 2012

Robotic Ablation of Atrial Fibrillation

Robotic Ablation of Atrial Fibrillation

Published on: May 29, 2015

Videos de Conceptos Relacionados

Amyloid Fibrils

Amyloid Fibrils

Amyloid fibrils are aggregates of misfolded proteins. Under most circumstances, misfolded proteins are either refolded by chaperone proteins or degraded by the proteasome. However, in the case of a mutation or a disease, these proteins can accumulate to form large clusters and often further assemble to form elongated fibers, called fibrils.
Amyloid deposits were observed as early as 1639 in the liver and the spleen. In 1854, Rudolph Virchow performed iodine staining,...

Amyloid Fibrils

Amyloid Fibrils

Bleeding in Fresh Concrete

Bleeding in Fresh Concrete

Bleeding in fresh concrete occurs when water from the mix rises to the surface. This happens because the mix's solid components fail to retain all the water as they settle, leading to separation where water collects at the top. The severity of bleeding can be measured by assessing the total settlement or by noting the decrease in height per unit height of concrete.
Bleeding can cause several issues in the concrete structure. Sometimes, the rising water gets trapped beneath large aggregate...

Fibril-associated Collagen

Fibril-associated Collagen

Fibril-associated collagens are a type of collagens present in the extracellular matrix with interrupted triple helices or FACIT (Fibril-associated collagens interrupted triple-helices). FACIT help connect and attach the collagen fibrils with each other as well as with other proteins of the extracellular matrix.
For example, the type II collagen fibrils in cartilage have covalently bound type IX fibril-associated collagens at regular intervals. Other types of fibril-associated collagens are...

Major Organs of the Digestive System

Major Organs of the Digestive System

The digestive system is responsible for the ingestion of food, secretion of enzymes, mixing and digesting food, absorption of the nutrients and defecation. The human digestive system consists of two major parts: the gastrointestinal tract and the accessory digestive organs.
Gastrointestinal tract:

Major Hormones and Their Functions

Major Hormones and Their Functions

Hormones, the biochemical messengers produced by endocrine glands, are pivotal in regulating bodily functions and maintaining homeostasis. Each hormone's balance is crucial; imbalances can lead to significant physiological disruptions. Major hormones include oxytocin, cortisol, epinephrine, estrogen, testosterone, thyroxine, growth hormone, insulin, and glucagon.
Oxytocin, produced in the hypothalamus and released by the pituitary gland, plays a role in social bonding, childbirth, and...