在未引起的静脉血栓塞栓症中,抗凝药停止后的连续D-二次体:来自REVERSE队列研究的数据
Yan Xu1, Faizan Khan2, Michael J Kovacs3
1School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada; Department of Medicine, University of Ottawa and The Ottawa Hospital, Ottawa, Canada.
Thrombosis research
|October 6, 2023
概括
连续D-二聚体检测可以确定在停止服用口服抗凝剂后,静脉血栓栓塞 (VTE) 复发风险较低的患者. D-二聚合物水平的变化也有助于预测VTE复发风险.
科学领域:
- 血液学 血液学 血液学
- 心血管医学 心血管医学
- 临床诊断 临床诊断 临床诊断
背景情况:
- 对于未引起的静脉血栓塞栓症 (VTE) 复发的现有风险分层工具的准确性有限,只有25%的患者被归类为低风险.
- 连续测量D-二次体显示有望改善在停止口服抗凝剂 (OAC) 后静脉瘤复发的预测.
研究的目的:
- 为了比较OAC停止和1个月随访时正常与升高D-二次体水平的患者的VTE复发率.
- 根据这些时间点之间的D-二次体水平 (∆D-二次体) 的绝对增加来评估VTE复发风险.
主要方法:
- 利用REVERSE队列,分析214名患者OAC停止和1个月随访时的串行D-二次体水平.
- 在两个时间点的正常D-二次体 (男性<490 ng/mL,其他<500 ng/mL) 患者与在任何时间点水平升高的患者之间比较VTE复发率.
- 根据D-二次元水平变化 (∆D-二次元) 评估VTE复发率,分为四分位数.
主要成果:
- 在任何一个时间点,D-二次数升高的患者的静脉瘤复发风险 (每年6.9%) 比在两个时间点正常水平的患者 (每年4.2%;HR 1.6) 高得多.
- 在具有不到2个HERDOO2标准的女性中,在两个时间点的正常D-二次数水平预测了非常低的复发风险 (每年0.8%).
- 最低∆D-二次方位的患者每年只有3%的静脉瘤复发风险,无论基线D-二次方位值如何.
结论:
- 序列正常的D-二元水平可以有效地识别患有复发性VTE风险较低的患者.
- 独立于其绝对值的D-二元水平 (∆D-二元) 的变化,可以作为VTE复发的有价值预测指标.
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