对于心房动和出血性透析的左心房尾闭塞
Balrik Singh Kailey1,2, Michael Koa-Wing1, Nilesh Sutaria1
1Imperial College Healthcare NHS Trust, London, UK.
Journal of cardiovascular electrophysiology
|November 14, 2023
概括
对于高出血风险患者来说,在左心房附属物阻塞 (LAAO) 后的最小抗血栓治疗可能是安全有效的,可能会减少有害出血事件. 需要进一步的研究来证实这些发现.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
背景情况:
- 左心房尾闭塞 (LAAO) 是心房动 (AF) 患有高出血风险的患者的另一种中风预防方法.
- 在LAAO后使用抗血栓性药物是标准的,但缺乏强有力的证据,特别是在高风险人群中.
研究的目的:
- 确定最佳的植入后抗血栓策略,用于接受LAAO的患有高出血风险的患者.
- 为了比较最小的抗血栓治疗与标准护理的安全性和有效性.
主要方法:
- 一个多学科小组建议为接受LAAO的高风险AF患者提供外科期药物治疗.
- 患者接受了最低限度的治疗 (没有抗血栓剂或单独的阿司匹林) 或标准护理 (12周的双重抗血小板/抗凝药).
- 包括死亡率,设备相关的血栓,中风和出血在内的结果在90天和长期使用生存分析进行了比较.
主要成果:
- 在90天后,这两个组中都没有出现与设备相关的血栓或中风.
- 与最低限度治疗相比,标准护理组的出血事件 (5/33比0/42) 和相关死亡 (3/33比0/42) 显著增加.
- 长期随访没有显示早期最小治疗的不良影响,大多数患者转向没有或单一的抗血小板治疗.
结论:
- 在高出血风险患者中,在LAAO后,短期抗血栓药物可能不必要,可能会增加危害.
- 最小的抗血栓治疗似乎是安全和有效的,需要在更大的前性研究中进一步调查.
相关概念视频
01:24Disorders of Hemostasis
957
Hemostasis, the process that stops bleeding after a blood vessel injury, is crucial for maintaining the integrity of the circulatory system. However, disorders of hemostasis can disrupt this delicate balance, leading to either excessive clotting or bleeding. These disorders can be broadly classified into thromboembolic disorders and bleeding disorders.
Thromboembolic Disorders
Two factors primarily cause thromboembolic conditions.
Thromboembolic Disorders
Two factors primarily cause thromboembolic conditions.
957
01:30Anticoagulant Drugs: Low-Molecular-Weight Heparins
719
Hemostasis is a crucial process that prevents excessive blood loss from damaged blood vessels. It involves various mechanisms such as vasoconstriction, platelet adhesion and activation, and fibrin formation. The importance of each mechanism depends on the type of vessel injury. In contrast, thrombosis is the abnormal formation of a blood clot within the blood vessels, leading to potential complications if the clot obstructs blood flow. Thrombosis can be caused by increased coagulability of the...
719