在接受皮肤冠状动脉干预的患者中,晚期出血事件在工作前的TAVR中发生
Marisa Avvedimento1, Francisco Campelo-Parada2, Erika Munoz-Garcia3
1Quebec Heart and Lung Institute, Laval University, Quebec City, Quebec, Canada.
JACC. Cardiovascular interventions
|September 13, 2023
概括
通过皮肤冠状动脉干预 (PCI) 进行过导管大动脉置换 (TAVR) 后的晚期出血事件 (LBEs) 在近8%的患者中发生,并增加死亡风险. 结合抗血小板和抗凝治疗会增加LBE的风险.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 老年心脏病学 老年心脏病学
背景情况:
- 在等待跨导管大动脉置换 (TAVR) 患者的皮肤冠状动脉干预 (PCI) 后,晚期出血事件 (LBEs) 尚不清楚.
- 在这种特定患者群体中,LBE的临床意义和发病率需要进一步调查.
研究的目的:
- 调查在TAVR之前接受PCI的患者中LBE的发病率,临床特征和相关因素.
- 确定LBE对临床结果的影响,包括TAVR后的死亡率.
主要方法:
- 一项多中心研究涉及1,457名接受TAVR并存活超过30天的患者.
- 晚期出血事件 (LBEs) 使用门学术研究联盟-2标准来定义,发生在TAVR后30天以上.
主要成果:
- 在7.9%的患者中,LBE发生,大多数事件是严重的或危及生命的.
- LBE的独立预测因素包括周围手术出血和双抗血小板药物加抗凝治疗.
- 在TAVR后,LBE与4年所有原因死亡风险显著增加有关.
结论:
- 晚期出血事件在需要PCI的冠状动脉疾病的TAVR患者中很常见,并且与较高的死亡率有关.
- 预防LBE的策略至关重要,特别是考虑到与联合抗血栓治疗相关的风险增加.
- 需要进行进一步的研究,以为这种高风险群体建立最佳的抗血栓治疗方案.
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