·威勒布兰德因子活动的早期术后变化与未来的出血和中风有关HeartMate 3患者
Parsa Jahangiri1, Kevin M Veen2, Iris van Moort3
1From the Department of Cardiology.
概括
早期术后威尔布兰德因子 (VWF) 活性测定预测左心室辅助器件 (LVAD) 接受者的出血和中风风险. 低于0.7的VWF:Act/Ag或VWF:CB/Ag比率表明胃肠道出血和出血性中风的风险较高.
科学领域:
- 心血管医学 心血管医学
- 血液学 血液学 血液学
- 生物标志物发现发现
背景情况:
- 胃肠道出血和中风是左心室辅助器件 (LVAD) 植入后的常见并发症,通常与血红相容性相关的不良事件 (HRAE) 相关.
- 了解这些HRAE的预测因素对于改善LVAD植入后的患者结果和管理策略至关重要.
研究的目的:
- 调查早期术后威尔布兰德因子 (VWF) 活性测定是否可以预测LVAD患者的胃肠道出血和中风风险.
- 分析早期术后VWF活动概况与长期HRAE之间的关联.
主要方法:
- 一项前性单中心研究包括74名HeartMate 3设备接收者.
- 术后测量了VWF活动测定 (VWF:活动/抗原和VWF:原结合/抗原比率).
- 线性混合效应模型和考克斯模型用于分析VWF轨迹和与晚期结果的关联.
主要成果:
- 植入后40天内,VWF:活性/抗原和VWF:原结合/抗原的比率显著下降.
- 早期术后比率≤0.7与显著更高的胃肠道出血 (HR:2.53-3.7) 和出血性中风 (HR:3.5-4.9) 的风险有关.
- 一个VWF:活动/抗原比≤0.7与缺血性中风风险降低有关 (HR:0.11).
结论:
- 早期的术后VWF:活动/抗原和VWF:原结合/抗原比率≤0.7作为HRAE的预测生物标志物.
- 这些VWF测定可以在长期LVAD支持期间识别患有胃肠道出血和出血性中风风险较高的患者.
- 在早期术后阶段监测VWF活动可以指导个性化管理,以减轻出血和中风风险.
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