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跨导管大动脉植入的抗血栓管理

Lina Ya'Qoub¹, Jelena Arnautovic², Musa Sharkawi³

¹Division of Structural Heart Disease, University of California (San Francisco), San Francisco, CA 93106, USA.

Journal of clinical medicine

|December 23, 2023

概括

通过导管大动脉植入术 (TAVI) 后的最佳抗血栓治疗已经发展. 大多数没有其他适应症的患者现在可以从TAVI后的单一抗血小板治疗中受益.

科学领域:

心血管医学心血管医学
干预心脏病学干预心脏病学
药理学药理学是指药理学的学科.

背景情况:

经过过导管大动脉植入 (TAVI) 后,最佳抗血栓治疗方案发生了显著的转变.
最近的大型临床试验重新塑造了TAVI后抗血栓治疗的基于证据的建议.

研究的目的:

提供对关键临床试验的叙述性综述,这些临床试验影响了TAVI后的抗血栓策略.
总结当前的指导方针建议,并确定TAVI后抗血栓治疗方面的知识差距.

主要方法:

进行了主要临床试验的叙事描述.
PubMed被用来识别相关的试验,使用关键词,如"透气管主动脉置换","透气管主动脉植入","抗血栓","抗血小板",和"抗凝".
这项研究是叙事性审查,而不是系统性审查或元分析.

主要成果:

大型试验 (POPULAR-TAVI A/B,ENVISAGE-TAVI AF,Galileo,ATLANTIS,ADAPT-TAVR) 提供了当前实践的信息.
对于大多数TAVI后没有其他抗凝血需要的患者,建议单次抗血小板治疗.
在具有高血栓和低出血风险的年轻患者中,可以考虑双重抗血小板治疗.

结论:

单一抗血小板治疗是大多数TAVI后患者推的抗血小板治疗策略.
应根据出血和血栓形成风险进行个性化的治疗,特别是在年轻患者中.

关键词:

这是一种抗凝血药物.抗血小板药物可以预防血小板.这是一种抗血栓的抗血栓药物.结构性心脏病是一种心脏病.穿过导管的大动脉植入装置.

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