在患有心房动和急性缺血性中风的患者中,左心房尾关闭,尽管服用抗凝药
Avia Abramovitz Fouks1, Shadi Yaghi2, Magdy H Selim3
1Neurology, Massachussets General Hospital, Harvard Medical School, Boston, MA, USA.
Stroke and vascular neurology
|June 11, 2024
概括
左心房尾关闭 (LAAC) 可能会降低非膜心房患者的中风风险,尽管服用口服抗凝剂,但患有急性缺血性中风. 这项研究发现,LAAC与每年中风复发率低相关,支持了进一步的试验.
科学领域:
- 心脏病学 心脏病学
- 神经学 神经学
- 医疗器械 医疗器械
背景情况:
- 在使用口服抗凝剂 (OAC) 的非膜性心房动 (NVAF) 患者中,急性缺血性中风 (AIS) 是越来越令人担忧的.
- 左心房尾关闭 (LAAC) 被探索为这些高风险患者的中风预防策略.
研究的目的:
- 为了评估内血管LAAC在NVAF患者的有效性和安全性,这些患者尽管接受OAC治疗,但经历了AIS.
- 评估LAAC后复发性AIS和症状性脑内出血 (ICH) 的发生率.
主要方法:
- 尽管有OAC,但患有AIS的NVAF患者接受了内血管LAAC (2015年1月 - 2021年10月) 的回顾性分析.
- 主要结局:LAAC后的复发性AIS. 安全结果:有症状的ICH.
- 收集关于中风复发,出血事件和OAC管理的后续数据.
主要成果:
- 29名患者 (平均年龄73.4岁,高CHA2DS2-VASc得分) 尽管有OAC,但接受了AIS的LAAC.
- 一名患者 (1.97/100患者年) 经历了LAAC后的AIS,明显低于预期风险 (8.44%).
- 一名患者在双重治疗期间出现了小ICH;大多数患者在OAC上出院.
结论:
- 尽管有OAC,LAAC在患有AIS的患者中显示年AIS复发率很低.
- 研究结果表明,LAAC在这个具有挑战性的患者群体中是预防中风的可行选择.
- 结果支持需要随机对照试验来确认LAAC在AIS-despite-OAC患者中的有效性.
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