预防复发性异常性静脉血栓栓塞
1Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA. sgoldhaber@partners.org
Circulation
|December 16, 2004
概括
长期抗凝药是安全和有效的预防异常性静脉血栓栓塞 (VTE) 复发. 万能抗凝药应该是默认的策略,除非有禁忌,未来的研究重点是风险分层.
科学领域:
- 心脏病学 心脏病学
- 血液学 血液学 血液学
- 血管医学 血管医学
背景情况:
- 异常性静脉血栓塞栓症 (VTE) 是一种慢性疾病,需要终身的复发预防策略.
- 针对异常性静脉血栓炎的延长抗凝治疗 (≤1年) 显示,在停止治疗后,长期益处有限.
- 之前的试验表明,新型抗凝血剂对长期VTE治疗有效.
研究的目的:
- 评估长期抗凝药的安全性和有效性,以预防复发性异常性静脉血栓性脑脊髓炎.
- 为了确定长期抗凝药是否有利于所有患者亚组,包括患有血栓性状况的患者.
主要方法:
- 分析了PREVENT,ELATE和THRIVE III临床试验中的数据.
- 包括患有异常性静脉瘤的患者,包括那些患有孤立的小腿深静脉血栓症的患者.
- 评估不同小组 (年龄,性别,遗传突变,VTE病史) 的结果.
主要成果:
- 长期抗凝药是一种安全有效的策略,用于管理异常性静脉瘤.
- 长期抗凝药的好处扩展到所有患者亚组,无论血栓友好状况如何.
- 这一策略对于首次发生的VTE事件和反复发生的VTE事件都有效.
结论:
- 全方位抗凝药应该是异常性静脉血栓炎的默认策略,除非有禁忌.
- 基于人群的实施可以防止VTE复发,治疗个性化最小.
- 未来的研究应该专注于风险分层方法,如d-二分体水平,超声波和风险名录,以确定最容易复发的患者.
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