与心房动模式相关的左心房关闭结果:综合分析
Mingzhong Zhao1,2,3, Jiangtao Yu3,4, Cody R Hou5
1Cardiovascular Center, Chengdu Shuangnan Hospital, Chengdu, China.
Frontiers in cardiovascular medicine
|June 6, 2024
概括
心房的模式没有影响左心房尾关闭后的结果. 左心房尾关闭可以降低中风和出血的风险,无论心房的类型如何.
科学领域:
- 心脏病学 心脏病学
- 电子生理学 电子生理学
- 医疗器械 医疗器械
背景情况:
- 心房动 (AF) 模式可能会影响左心房关闭 (LAAC) 后的临床结果.
- 关于AF类型对LAAC后心脑血管事件的差异影响存在争议.
- 了解这些差异对于风险分层和患者管理至关重要.
研究的目的:
- 评估AF类型的影响,特别是偏激性AF (PAF) 与非偏激性AF (NPAF),在LAAC后对心脑血管事件风险的影响.
- 为了比较接受LAAC的PAF和NPAF患者之间的长期结果.
主要方法:
- 对410名接受LAAC的AF患者进行了回顾性分析.
- 将AF分为PAF和NPAF组的分类.
- 组间基线特征,手术数据,并发症和长期结果 (血栓栓塞,出血,死亡率) 的比较.
- 使用了倾向性得分匹配 (PSM) 分析.
主要成果:
- NPAF患者年龄较大,男性更频繁,慢性脏病 (CKD) 发病率更高.
- 在PAF和NPAF组之间,程序成功和程序前并发症是相似的.
- 长期随访 (2.2±1.5年) 显示,小组之间的血栓栓塞,严重出血或与器件相关的血栓 (DRT) 没有显著差异.
- 最初,NPAF与较高的全因死亡率,非心血管死亡率和复合疗效终点相关,但在PSM之后,这种情况消失了.
- 观察到的血栓栓塞和大出血的风险低于CHA2DS2-VASc和HAS-BLED分数所预测的.
结论:
- 左心房附属体的关闭与血栓栓塞和严重出血的风险降低有关,无论AF类型如何.
- 尽管NPAF患者经常出现更多的并发症,但NPAF与LAAC后的PAF相比,长期结果并不更差,特别是通过PSM计算基线差异后.
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