早期非程序性出血 在左前庭尾闭塞后
Jules Mesnier1, Ignacio Cruz-González2, Paul Guedeney3
1Quebec Heart and Lung Institute, Laval University, Quebec City, Quebec, Canada.
JACC. Cardiovascular interventions
|July 18, 2024
概括
在左心房尾封闭 (LAAO) 后的早期非程序性出血影响7%的患者,并增加死亡风险. 出院时的双抗血小板疗法是关键预测因素,强调需要仔细选择抗血小板策略.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 血栓形成研究研究
背景情况:
- 接受左心房尾闭塞 (LAAO) 的患者面临高出血风险.
- 强化抗血栓治疗在LAAO后至关重要,以预防与设备相关的血栓形成.
研究的目的:
- 确定LAAO后早期非程序性出血的发生率,后果和预测因素.
- 评估早期出血对患者结局的影响.
主要方法:
- 多中心研究涉及1649名接受LAAO的患者.
- 早期非程序性出血定义为植入后3个月内发生的事件,使用门学术研究联盟-2标准进行评估.
- 45天后进行的敏感性分析.
主要成果:
- 121名患者 (7.3%) 经历了早期的非程序性出血,其中57%被归类为重大.
- 预测因素包括出院时的双抗血小板治疗 (DAPT),之前的胃肠道出血和多个之前的出血部位.
- 早期非程序性出血独立预测增加所有原因死亡率 (aHR: 1.53).
结论:
- 早期非手术性出血发生在大约7%的LAAO患者中,发生在3个月内,通常是严重的,并且与较高的死亡率有关.
- 出院时的DAPT显著增加了早期非程序性出血的风险.
- 这些发现强调了出血风险评估在指导LAAO后的抗血栓治疗策略中的关键作用.
相关概念视频
Cardiac Catheterization II: Right Heart Catheterization
Right Heart Catheterization: An OverviewRight heart catheterization is an invasive diagnostic procedure that measures right-sided cardiac and pulmonary artery pressures, calculates cardiac output, and identifies intracardiac shunts. It provides detailed hemodynamic data essential for diagnosing and managing various cardiovascular conditions, such as pulmonary hypertension.Access SitesCommon access sites for right heart catheterization include the internal jugular vein in the neck region, the...
Cardiac Catheterization III: Left Heart Catheterization
Left heart catheterization is an invasive diagnostic procedure used to evaluate the function and structure of the left side of the heart. It is generally performed to diagnose and treat cardiovascular conditions such as valve abnormalities, coronary artery disease, and congenital heart defects.Diagnostic and therapeutic purposesLeft heart catheterization serves various diagnostic and therapeutic purposes, including:Assessing coronary artery bypass grafts.Evaluating coronary artery disease in...
Aneurysm III: Interprofessional Care
Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...


