患有晚期慢性病 (第四和第五阶段) 的患者的左心房附属体封闭. 长期跟进 长期跟进
Sergio López-Tejero1,2,3, Pablo Antúnez-Muiños1,2,3, Pilar Fraile-Gómez4
1Department of Cardiology, Complejo asistencial universitario de Salamanca (CAUSA), Salamanca, Spain.
概括
左心房附属体封闭 (LAAO) 是有效的预防中风的患者,晚期慢性病 (A-CKD). 这种程序为这种高风险人群提供了口服抗凝药的安全替代方案.
科学领域:
- 心脏病学 心脏病学
- 腎臟病學 (nephrology) 是一種醫學.
- 干预心脏病学 干预心脏病学
背景情况:
- 晚期慢性病 (A-CKD) 和心房的患者面临高血栓和出血事件的风险.
- 左心房尾阻塞 (LAAO) 是口服抗凝剂的潜在替代方案,用于预防这一群体的血栓栓塞事件.
研究的目的:
- 评估LAAO在被诊断为A-CKD的患者的长期结果.
- 为了比较LAAO在患有和没有A-CKD的患者中的安全性和有效性.
主要方法:
- 在2009年至2022年5月期间接受LAAO治疗的573名患者进行了比较研究.
- 患者被分为两组:患有A-CKD (eGFR<30mL/min/1.73m2) 和没有A-CKD的患者.
- 分析了长期随访数据,以比较中风率,出血事件和死亡率.
主要成果:
- 在A-CKD和非A-CKD组之间1年或5年随访后,没有观察到中风发生率的显著差异.
- 虽然A-CKD患者经历了更多的出血事件,但大出血 (BARC ≥3) 率在1年或5年内没有显著差异.
- 甲型心脏病患者在5年内死亡率较高 (HR:1.84,p=0.012).
- 全球LAAO的程序成功率高达99.1%.
结论:
- LAAO是一种有效和安全的治疗方法,用于预防A-CKD患者的缺血事件.
- 在高风险的A-CKD患者中,LAAO可以作为口服抗凝药的可行替代品来管理心房动.
- 尽管整体出血较高,但LAAO在A-CKD患者的主要出血事件方面表现出可比的安全性.
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