直接口服抗凝剂会影响皮肤冠状动脉干预后的激活凝血时间和出血事件
Eiji Shibahashi1, Takuro Abe2, Kazuho Kamishima3
1Department of Cardiovascular Intervention, Tokyo Women's Medical University Adachi Medical Center, Tokyo, Japan.
The American journal of cardiology
|August 2, 2023
概括
直接口服抗凝剂 (DOAC) 在皮肤冠状动脉干预 (PCI) 过程中增加激活凝血时间 (ACT). 接受DOAC治疗的患者在PCI后出现更高的出血率,与未接受DOAC治疗的患者相比.
科学领域:
- 心脏病学 心脏病学
- 药理学 药理学是指药理学的学科.
背景情况:
- 穿皮冠状动脉干预 (PCI) 期间高激活凝血时间 (ACT) 会增加出血风险.
- 直接口服抗凝剂 (DOAC) 对PCI期间ACT动力学和临床结果的影响尚不清楚.
研究的目的:
- 研究在接受PCI的患者中DOAC使用,ACT水平和不良临床事件之间的关系.
主要方法:
- 对246名接受PCI的患者进行了观察性研究.
- 患者被分为DOAC使用者 (n=31) 和非使用者 (n=215).
- 在PCI期间测量未分离肝素前和30分钟后的ACT;在30天内追踪出血和血栓栓塞事件.
主要成果:
- 与非使用者相比,DOAC使用者在服用赫巴林之前和之后的ACT水平显著更高 (p < 0.001).
- 在DOAC使用者 (16.1%) 和非使用者 (4.7%) 中,出血事件的发生率显著高 (p = 0.028).
- 系统性血栓栓塞率较低,在各组之间相似 (0%对3.7%,p = 0.60).
结论:
- 使用DOAC与PCI期间ACT升高有关.
- 接受DOAC治疗的患者在PCI后经历出血事件的发生率更高.
- 需要进一步的研究,以优化使用DOACs的PCI患者的抗凝策略.
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