患有心室辅助器件的患者的阿司匹林耐药性:一项随访研究
Tobias Flieder1, Sonja Blaesen1, Katrin Schulte1
1Herz- und Diabeteszentrum Nordrhein-Westfalen, Universitätsklinik der Ruhr-Universität Bochum, Institut für Laboratoriums- und Transfusionsmedizin, Bad Oeynhausen, Germany.
Artificial organs
|March 30, 2024
概括
在左心室辅助器 (LVAD) 患者中测试阿司匹林耐药性 (ASA) 可以识别那些血栓形成风险较高的人,特别是使用HeartWare或HeartMate II设备. 这种测试可以指导治疗调整,以防止严重的并发症.
科学领域:
- 心脏病学 心脏病学
- 生物医学工程 生物医学工程
- 药理学 药理学是指药理学的学科.
背景情况:
- 左心室辅助器 (LVAD) 患者面临高血栓栓塞和出血事件的风险,尽管联合抗凝药.
- 已知阿司匹林耐药性 (ASA耐药性),但其在指导LVAD患者治疗调整中的临床实用性仍在争论中.
- 目前的治疗策略往往难以平衡LVAD接受者的有效性和安全性.
研究的目的:
- 调查阿司匹林耐药性和LVAD患者血栓形成风险之间的关联.
- 评估实验室测试对阿司匹林耐药性在预测不良血栓事件的实用性.
- 为了比较抗阿司匹林和抗阿司匹林敏感的LVAD患者中血栓和出血事件的发生率.
主要方法:
- 使用光传递聚合计 (LTA) 和阻抗聚合计 (IPA) 评估了132名LVAD患者 (HeartWare,HeartMate II,HeartMate 3) 的阿司匹林耐药性.
- 患者被监测了长达7年的血栓形成.
- 分析了血小板功能,以确定抵抗水平.
主要成果:
- 抗阿司匹林与血栓形成的风险增加显著相关,无论使用的测试方法如何 (LTA:OR=6.20; IPA:OR=12.14).
- 在HartMate 3的阿司匹林耐药患者中没有观察到血栓事件.
- 在阿司匹林耐药和阿司匹林敏感患者之间,没有发现出血事件的显著差异.
结论:
- 对阿司匹林耐药性的实验室检测似乎是有价值的,用于识别高血栓形成风险的LVAD患者 (HeartWare,HeartMate II).
- 需要进行进一步的研究,以确定基于耐药性测试的抗血小板治疗的修改是否可以预防血栓形成.
- 在HeartMate 3患者中,阿司匹林治疗的必要性需要进一步调查,因为在耐药病例中没有血栓形成.
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