里瓦洛克萨班在患有持续心房的患者中出现脏梗塞的失败:一个病例报告
Shudipan Chakraborty1, Fnu Salman1, Moaaz Baghal2
1Internal Medicine, Mercy Health - St. Vincent Medical Center, Toledo, USA.
Cureus
|February 16, 2024
概括
直接口服抗凝剂 (DOAC) 首选用于心房,但很少发生失败. 这一案例突显了利瓦洛克萨班的失败导致脏病发作,与左心房自发性心声学对比相关.
科学领域:
- 心脏病学 心脏病学
- 药理学 药理学是指药理学的学科.
- 腎臟病學 (nephrology) 是一種醫學.
背景情况:
- 直接口服抗凝剂 (DOAC) 是对心房的抗凝剂的标准护理,比维生素K对抗剂具有优势.
- DOACs具有有利的安全性,减少大出血,消除了常规国际规范化比率 (INR) 监测的需要.
- 尽管它们是有效的,但已经记录了DOAC失效的情况,需要对潜在机制和临床影响进行进一步的研究.
研究的目的:
- 报告一种罕见的直接口服抗凝剂 (DOAC) 失败病例.
- 调查左心房自发性心声学对比度和里瓦洛克萨班失败之间的潜在关联.
- 为了突出左梗塞的临床表现,作为抗凝失败的结果.
主要方法:
- 病例报告详细介绍了一名患有里瓦洛克萨班失效的患者.
- 通过胸腔回声心脏成像来可视化心脏结构,并识别潜在的栓塞源.
- 在左心房内自发的心声对比被确定为一个重要的发现.
主要成果:
- 这位患者出现了确定的左梗塞,表明了栓塞事件.
- 胸前回声心脏成像显示左心房内密集的自发回声心脏成像对比.
- 这一案例代表了一例罕见的里瓦洛克萨班失败案例,尽管遵守了处方治疗.
结论:
- 这一案例强调了直接口服抗凝剂 (DOAC) 失效的可能性,即使是像利瓦洛克萨班这样的常见处方药.
- 在左心室中存在密集的自发回声心脏学对比度可能意味着血栓栓塞事件的风险增加.
- 需要进一步的研究来阐明自发回声心脏学对比度在DOAC患者中的预测价值,并优化抗凝策略.
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