基于高出血风险的临床结果,在患有下肢外周动脉疾病的患者中,这些患者接受了内血管治疗
Naoki Yoshioka1, Takahiro Tokuda2, Akio Koyama3
1Department of Cardiology, Ogaki Municipal Hospital, Ogaki, Japan.
概括
大多数患有外周动脉疾病 (PAD) 的患者接受内血管治疗 (EVT),患有高出血风险 (HBR). 较高的HBR得分与EVT后增加的出血,死亡率和缺血事件相关.
科学领域:
- 血管外科 血管外科
- 干预心脏病学 干预心脏病学
- 心血管研究研究心血管研究
背景情况:
- 内血管疗法 (EVT) 是有效的症状下肢外周动脉疾病 (PAD).
- 患有PAD的患者经常存在高出血风险 (HBR),但对EVT后的HBR数据有限.
- 调查HBR患病率及其对PAD患者EVT后结果的影响至关重要.
研究的目的:
- 为了确定在EVT后患有下肢PAD的患者中HBR的患病率和严重程度.
- 评估HBR与临床结果之间的关联,包括主要出血,全因死亡率和缺血事件.
- 评估学术研究联盟对高出血风险 (ARC-HBR) 标准在分层风险中的有用性.
主要方法:
- 对732名连续接受EVT的患有下肢PAD的患者进行了回顾性分析.
- 应用ARC-HBR标准来评估HBR患病率和严重程度.
- 根据ARC-HBR得分将患者分为风险组 (低,中等,高,非常高) 的分类.
- 随访2年,记录主要出血事件 (BARC类型3或5),所有原因死亡率和缺血事件 (MI,中风,ALI).
主要成果:
- 在研究队列中观察到高HBR患病率 (78.8%).
- 主要出血事件 (9.7%),全因死亡率 (18.7%) 和缺血事件 (6.4%) 发生在2年内.
- 大型出血,全因死亡率和缺血事件的显著增加与更高的ARC-HBR得分相关 (例如,高风险:aHR 5.62;非常高风险:aHR 10.37).
结论:
- 大多数接受EVT的下肢PAD患者表现出HBR.
- 根据ARC-HBR标准的定义,HBR与EVT后出血,死亡率和缺血事件的风险增加显著相关.
- ARC-HBR标准有效地对接受EVT的PAD患者的出血风险进行分层,有助于临床决策.
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