机械大动脉的低强度抗凝治疗30年的结果
Shintaro Sawa1, Satoshi Saito2, Kozo Morita2
1Department of Cardiovascular Surgery, Tokyo Women's Medical University, 8-1 Kawada, Shinjuku, Tokyo, 162-8666, Japan. sawa.shintaro@twmu.ac.jp.
Heart and vessels
|February 23, 2024
概括
低强度抗凝药 (INR 1.6-2.5) 对机械大动脉置换患者是安全有效的. 这种方法显示出良好的长期结果,老年是不良事件的主要风险因素.
科学领域:
- 心血管外科心血管外科
- 临床药理学 临床药理学
- 生物医学工程 生物医学工程
背景情况:
- 对于机械心脏门的低强度抗凝药的长期安全性和有效性尚未得到充分证实.
- 用机械假肢替换大动脉 (AVR) 需要进行抗凝管理.
- 了解机械门和鼻节律患者的结果至关重要.
研究的目的:
- 评估使用机械假肢进行AVR后低强度抗凝治疗的长期安全性和有效性.
- 评估患者的存活率和主要心脏和脑血管不良事件 (MACCE).
- 在这个队列中确定心脏死亡和MACCE的风险因素.
主要方法:
- 对519名患者进行了回顾性队列研究,这些患者接受了单次AVR,在鼻腔节律中使用圣犹大医院的胆叶片.
- 医疗记录审查和随访问卷,目标INR为1.6-2.5.5.
- 分析了平均随访时间为19.9年的生存率,MACCE发生率和风险因素 (9793个患者年).
主要成果:
- 平均INR为2.03 (SD:0.54) 的时间.
- 心脏病死亡的20年和30年生存率分别为93.6%和85.2%.
- 高龄 (≥70岁) 是心脏死亡和MACCE的唯一显著风险因素;INR<2.0不是MACCE的显著风险因素,包括血栓塞栓症或出血.
结论:
- 低强度抗凝药 (INR 1.6-2.5) 是安全有效的,用于患者与AVR后鼻节律与胆叶片机械.
- 这种抗凝血策略显示出有利的长期结果,延伸到30年以后.
- 年龄是影响机械心脏门患者结果的关键因素.
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