在未引起静脉血栓栓塞的患者中,使用隐性类分析的子类表型
Shinya Ikeda1, Yugo Yamashita2, Takeshi Morimoto3
1Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan; Department of Pharmacology, Shiga University of Medical Science, Otsu, Japan.
Thrombosis research
|April 23, 2024
概括
潜在类分析确定了三种不同的患者亚组,用于未引起的静脉血栓塞栓症 (VTE). 患有多种并发症的老年患者有较高的抗凝药中止和出血风险,告知个性化VTE管理.
科学领域:
- 心脏病学 心脏病学
- 血液学 血液学 血液学
- 医疗信息学 医疗信息学
背景情况:
- 未引起的静脉血栓塞栓症 (VTE) 是一个重大的临床挑战.
- 根据表型对VTE患者进行分类可能有助于定制管理策略.
- 隐性类分析 (LCA) 提供了一种识别不同患者子组的方法.
研究的目的:
- 将LCA应用于大量VTE患者的注册表,以识别不同的表型.
- 在已识别的VTE子组中比较临床特征和结果.
- 探索表型化对个性化抗凝策略的实用性.
主要方法:
- 使用COMMAND VTE Registry-2数据库,包括1556名未引起的VTE患者.
- 基于8个临床相关变量,使用LCA进行了聚类.
- 在确定的子组中,比较了临床特征和3年和5年的结果 (抗凝药停用,复发性VTE,严重出血).
主要成果:
- 确定了三个不同的VTE患者亚组 (I类:年轻人,II类:年长但并发病较少,III类:年长但并发病较多).
- 第三类患者出现了最高的3年抗凝药中止率 (48.4%) 和5年大出血发生率 (17.8%).
- 在这三个类别中,在5年内复发的VTE发病率中没有发现显著差异.
结论:
- 实际上,LCA有效地将未引起的VTE患者分为不同的表型.
- 这些表型与临床结果的不同风险有关,特别是出血.
- 基于表型的分类有可能指导在VTE管理中的个性化抗凝策略.
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