生物假肢大动脉置换后的大脑微栓塞:华法林加阿司匹林与仅阿司匹林的比较
Talal Al-Atassi1, Khanh Lam, Melissa Forgie
1Division of Cardiac Surgery, University of Ottawa, Ottawa, Canada.
Circulation
|September 12, 2012
概括
单独的阿司匹林与华法林加阿司匹林在生物修饰性大动脉置换 (bAVR) 后预防大脑微栓塞方面同样有效. 这项研究表明,阿司匹林单一治疗可能对没有其他抗凝血需求的患者是安全的.
科学领域:
- 心血管医学 心血管医学
- 神经外科 神经外科
- 药理学 药理学是指药理学的学科.
背景情况:
- 有限的人类数据存在阿司匹林单疗法与华法林加阿司匹林预防大脑微栓塞后生物修饰性大动脉置换 (bAVR).
- 大脑微栓塞在经过bAVR的早期术后期是令人担忧的.
研究的目的:
- 为了比较阿司匹林单疗法与华法林加阿司匹林在预防bAVR后大脑微栓塞的疗效.
- 评估这些抗血栓治疗方案对血小板功能的影响.
主要方法:
- 预期招募56名接受bAVR而没有其他抗凝药指示的患者.
- 患者接受了华法林加阿司匹林或仅用阿司匹林.
- 在基线和1个月,通过中脑动脉 (MCA) 微栓塞信号 (MES) 量化的大脑微栓塞.
- 血小板功能分析 (PFA) 评估了关闭时间.
主要成果:
- 在基线或1个月的两组之间,MES患者比例没有显著差异.
- 只有阿司匹林和华法林加阿司匹林组之间的总MES和PFA是相当的.
- 在两组中都没有发生死亡,中风或过渡性缺血性发作,在1年的随访中.
结论:
- 阿司匹林单疗法和华法林加阿司匹林在bAVR后早期对大脑微栓塞和血小板功能表现出同等效果.
- 这些发现支持在选择的bAVR患者中安全使用阿司匹林单一治疗,而这些患者缺乏其他抗凝血疗法.
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