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在加拿大安大略省接受左心室尾闭塞手术的当代患者的长期临床结果

Sheldon M Singh^1,2, Feng Qui³, Harindra C Wijeysundera^1,2,3,4

¹Schulich Heart Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.

|October 25, 2023

概括

穿皮左心房尾封闭 (LAAO) 为心房患者提供中风预防. 这项研究发现,在加拿大安大略省,长期中风和出血率较低,但死亡率高且不变.

科学领域:

心脏病学心脏病学
干预心脏病学干预心脏病学
公共卫生公共卫生

背景情况:

穿皮左心房尾阻塞 (LAAO) 是一种中风预防替代方案,用于那些不能服用口服抗凝药的心房的患者.
关于LAAO使用和结果的现实数据有限,特别是长期跟踪.
本研究报告了加拿大安大略省LAAO的患者特征,程序并发症和长期临床结果.

研究的目的:

评估皮肤穿左心房尾闭塞 (LAAO) 程序的现实世界利用和临床结果.
评估与LAAO相关的程序并发症,中风率,出血事件,再住院和死亡率.
为加拿大人口提供有关LAAO长期有效性和安全性的见解.

主要方法:

一项回顾性队列研究确定了2013年4月1日至2022年3月31日期间在加拿大安大略省接受LAAO的所有患者.
使用链接的行政数据库收集患者人口统计,临床数据和程序特征.
结果包括7天和30天的手术并发症,以及中风,出血,全因再住院和死亡的长期发病率.

主要成果:

这项研究包括549名患者 (平均年龄75±8岁,66%是男性),平均CHA2DS2-VASc得分高 (4.4±1.6).
在长达2.6年的平均随访期间,中风发生在2.8% (1.1/100患者年),出血发生在10% (4.0/100患者年),再入院发生在63%的病例中.
总死亡率为29% (11/100患者年),在研究期间没有显著变化.

结论:

在加拿大安大略省的人群中,经皮质左心房尾闭塞 (LAAO) 后的长期中风和出血率较低.
在接受LAAO治疗的患者中,全因死亡率很高,并在整个研究期间保持一致.
这些发现强调了需要在接受LAAO的患者中继续监测和风险分层.

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