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心脏门手术后的抗血栓治疗:英国当代实践

Nabila Laskar¹, Christopher D Bayliss², Bilal H Kirmani³

¹Department of Cardiology, Barts Heart Centre, London, UK.

Interdisciplinary cardiovascular and thoracic surgery

|May 5, 2024

概括

在心脏门手术后使用抗血栓药物的做法在英国有很大差异. 需要更多的研究来建立最佳策略,以治疗术后使用口服抗凝剂和抗血小板剂.

科学领域:

心脏病学心脏病学
心血管外科心血管外科
药理学药理学是指药理学的学科.

背景情况:

最佳的抗血栓药物策略生物假肢心脏门置换/修复后缺乏高质量的数据.
国际指导方针显示差异,反映了证据差距.

研究的目的:

在英国进行心脏门手术后记录当前的抗血栓药物处方模式.
评估口服抗凝剂 (OAC) 和抗血小板剂使用的变化.

主要方法:

一项调查被发送给英国的咨询心脏外科医生.
评估OAC和/或抗血小板药物的使用在生物修饰性大动脉/心心门置换或心心门修复后,在没有其他迹象的鼻节律患者中.
在心房动患者中,评估了心房膜修复后的抗凝剂选择.

主要成果:

外科医生的反应 (40%) 显示了不同的处方:生物假体大动脉替代有利于初始 (76%) 和终身 (53%) 抗血小板治疗.
生物假体中枢置换显示初始OAC (48%) 与抗血小板药物 (42%) 使用量几乎相同,大多数人随后处方终身抗血小板治疗.
中枢修复策略包括终身单抗血小板 (34%),3个月的OAC,其次是抗血小板 (20%),没有药物 (20%),或3个月的OAC (16%).

结论:

在英国心脏门手术后使用抗血栓药物存在相当大的差异.
由于缺乏高质量的证据,需要随机研究来指导临床实践.
需要基于证据的指导方针,用于心脏门干预后的抗血栓治疗.

关键词:

抗凝剂是一种抗凝剂.大动脉门的大动脉门达成共识达成共识中心门的中心门.血小板聚合抑制剂血小板聚合抑制剂沃尔法林的战争

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