在MOMENTUM 3研究的长期队列中对中风的全面分析
Paolo C Colombo1, Mandeep R Mehra2, Daniel J Goldstein3
1Columbia University Medical Center, New York, NY (P.C.C.).
Circulation
|December 28, 2018
概括
与HeartMate II (HMII) 相比,HeartMate 3 (HM3) 显著减少了高级心力衰竭患者的长期中风事件. 无论类型或严重程度如何,中风的发生预示着较低的2年生存率.
科学领域:
- 心脏病学
- 神经学
- 生物医学工程
背景情况:
- 之前的MOMENTUM 3研究显示,与HeartMate II (HMII) 相比,使用HeartMate 3 (HM3) 左心室辅助装置 (LVAD) 的中风较少.
- 在接受HM3或HMII治疗的患者中,该分析详细检查了2年内发生的中风事件.
研究的目的:
- 综合分析HM3与HMII设备支持的患者中风的纵向发生,临床相关性,模式和结果.
- 确定中风的预测因素,并评估中风对长期生存的影响.
主要方法:
- 在晚期心力衰竭患者中比较HM3 (离心流) 和HMII (轴流) 的随机对照试验.
- 使用多变量分析来评估基线和植入后的中风相关性.
- 确定了中风的纵向模式 (出血与缺血,致残与非致残) 以及它们与2年结局的关联.
主要成果:
- 在361名患者中,发生了65例中风. 长期中风发生率 (181-730天) 是HM3 (0. 04事件/ 患者年) 与HMII (0. 13事件/ 患者年) 的3. 3倍.
- 血压和抗血栓治疗方案没有直接关联.
- 与没有中风的患者相比,中风事件显著降低了2年生存率 (43% - 57%).
结论:
- 与HMII装置相比,HM3显著降低了中风率,特别是在长期 (> 6个月) 中.
- 无论类型或严重程度如何,中风的发生是LVAD患者2年临床结果不佳的重要预测因素.
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