抗血栓药物治疗和机械大动脉置换后的主要并发症
Rikhard Björn1, Joonas Lehto1, Markus Malmberg1
1Heart Center, Turku University Hospital and University of Turku, Turku, Finland.
The American journal of cardiology
|August 6, 2023
概括
接受机械大动脉置换 (AVR) 的患者面临的重大出血风险高于中风风险,尽管维生素K对抗剂 (VKA) 治疗. 管理出血风险对于改善AVR后的结果至关重要.
科学领域:
- 心脏病学 心脏病学
- 血管外科 血管外科
- 药理学 药理学是指药理学的学科.
背景情况:
- 机械动脉置换 (AVR) 需要使用维生素K对抗剂 (VKA) 进行终身抗凝治疗,以预防血栓栓塞事件.
- 虽然VKA对预防中风有效,但它们显著增加出血并发症的风险.
研究的目的:
- 评估机械AVR后抗血栓治疗的疗效和安全性.
- 评估机械AVR患者中风和出血事件的发生率,时间和特征.
主要方法:
- 一项队列研究,包括308名接受隔离机械AVR的患者.
- 对306名患者 (99.4%) 收集了随访数据,随访时间中位数为7.3年.
主要成果:
- 大型出血发生的频率明显高于大型中风 (事件率为每100个患者年3.1比0.5).
- 在30天和长期随访后,大出血的风险是大中风的5倍.
- 在长期随访期间,胃肠道出血是最常见的部位 (41.7%);脑内出血发生在18.3%的出血中.
结论:
- 机械AVR后的抗血栓治疗在中风预防方面表现出良好的疗效,但由于高出血率,安全性不足.
- 大型出血是一种频繁且临床相关的并发症,需要改善可修改出血风险因素的管理.
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