脑小血管疾病在抗血栓治疗期间出血风险的负担:在抗血栓治疗中出血2研究研究
Kanta Tanaka1, Kaori Miwa1, Masatoshi Koga1
1Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan.
Annals of neurology
|December 26, 2023
概括
增加大脑小血管疾病 (SVD) 负担显著增加了服用抗血栓剂的患者发生重大出血的风险,包括内出血. SVD评分预测出血,指导更安全的抗血栓治疗.
科学领域:
- 神经学 神经学
- 心血管医学 心血管医学
- 放射学 放射学是一门学科.
背景情况:
- 大脑小血管疾病 (SVD) 常见于患有脑血管或心血管疾病的患者.
- 抗血栓剂经常被处方给这些患者,但携带出血的风险.
- SVD负担与抗血栓相关出血风险之间的关系需要进一步阐明.
研究的目的:
- 为了确定与大脑小血管疾病 (SVD) 负担相关的抗血栓相关出血的过度风险.
- 调查各种出血事件和缺血事件的SVD得分的预测值.
主要方法:
- 这是一项观察性前性队列研究,涉及52个日本医院的5250名患者 (2016-2019).
- 纳入治疗口服抗血栓剂的脑血管或心血管疾病患者.
- 基线多模式MRI被用于计算SVD总得分;主要结果是严重出血.
主要成果:
- 较高的SVD得分与较高的重大出血发病率相关 (得分为4比0的aHR=5.47) 和内出血 (aHR=9.29).
- 在SVD得分为4的患者中,观察到额外内主要出血 (aHR = 3.43) 和胃肠道出血 (aHR = 2.54) 的显著增加.
- 缺血事件的发生率也随着SVD得分的提高而增加 (得分为4比0的aHR=1.76).
结论:
- 总SVD得分是内出血和可能的外出血的重要预测指标.
- 大脑SVD负担对于评估抗血栓治疗的安全性具有临床意义.
- SVD评估可能有助于个性化抗血栓治疗策略,以最大限度地降低出血风险.
相关概念视频
01:24Disorders of Hemostasis
922
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.
922
01:30Anticoagulant Drugs: Low-Molecular-Weight Heparins
706
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...
706
01:18Anticoagulant Drugs: Vitamin K Antagonists and Direct Oral Anticoagulants
1.2K
Oral anticoagulants are vital tools in preventing and treating blood clotting disorders. This diverse class of medications can be categorized as vitamin K antagonists, exemplified by warfarin, and direct thrombin inhibitors (DTIs), such as dabigatran, as well as factor Xa inhibitors, including rivaroxaban.
Warfarin, a prominent vitamin K antagonist family member, exerts its effect by inhibiting the enzyme VKORC1 (vitamin K epoxide reductase complex 1). By hindering this enzyme, warfarin...
Warfarin, a prominent vitamin K antagonist family member, exerts its effect by inhibiting the enzyme VKORC1 (vitamin K epoxide reductase complex 1). By hindering this enzyme, warfarin...
1.2K
01:20Antiplatelet Drugs: Prostaglandin Synthesis, P2Y12 and Glycoprotein IIb/IIIa Inhibitors
526
Antiplatelet drugs emerge as frontline defenders against the insidious threat of thromboembolic diseases, where abnormal clots obstruct vital blood vessels. These drugs stand as bulwarks, inhibiting platelet aggregation and clot formation, thereby mitigating the risk of life-threatening conditions like myocardial infarction, coronary artery disease, and thrombotic strokes.
Prostaglandin synthesis inhibitors, exemplified by the widely known aspirin, wield their power by irreversibly acetylating...
Prostaglandin synthesis inhibitors, exemplified by the widely known aspirin, wield their power by irreversibly acetylating...
526
01:28Esophageal Varices-II: Clinical Features and Management
71
Esophageal varices often manifest as gastrointestinal bleeding episodes, presenting symptoms like hematemesis (vomiting of blood), hematochezia (passing fresh blood via the rectum), and melena (black, tarry stools). Other signs can include weight loss, anorexia, abdominal discomfort, jaundice, pruritus, altered mental status, and muscle cramps.
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol...
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol...
71
00:49The Blood-brain Barrier
47.4K
Overview
47.4K