在心房动中预防中风的左心房尾关闭:目前的状况和前景
Ulf Landmesser1,2,3,4, Carsten Skurk1,4, Apostolos Tzikas5
1Department of Cardiology, Angiology and Intensive Care Medicine, Deutsches Herzzentrum der Charite (DHZC), Hindenburgdamm 30, 12203 Berlin, Germany.
European heart journal
|July 19, 2024
概括
左心房尾关闭 (LAAC) 为减少心房患者中风风险提供了口服抗凝药的替代方案. 目前正在进行的试验和手术方法正在扩大其作用和安全性.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 医疗器械 医疗器械
背景情况:
- 心房动 (AF) 显著增加了中风和全身栓塞的风险.
- 左心房附属体 (LAA) 是AF患者血栓栓塞的主要来源.
- 口服抗凝药是标准的,但LAA闭合 (LAAC) 是一个新兴的替代方案.
研究的目的:
- 审查左心室尾关闭 (LAAC) 的不断发展的领域.
- 讨论最近的临床数据,正在进行的研究和LAAC的局限性.
- 突出LAAC作为一种替代性或补充性治疗,用于降低AF中风风险.
主要方法:
- 对中等规模的随机临床研究进行了综述,比较了以导管为基础的LAAC与维生素K对手.
- 从正在进行的随机临床试验中分析数据,将LAAC与最佳医疗保健 (包括NOAC) 进行比较.
- 包括LAAOS III关于心脏手术期间手术LAAC的研究结果.
主要成果:
- 基于导管的LAAC已经证明了有效性和安全性,随着设备和技术的不断改进.
- 在LAAOS III研究中,手术LAAC在接受抗凝药治疗的AF患者中降低了中风风险.
- 越来越多的证据支持LAAC,许多试验评估了其在各种临床环境中的有效性.
结论:
- 左心房尾关闭是AF相关血栓栓塞的快速发展的治疗选择.
- 进一步的研究和正在进行的试验至关重要,以确定最佳使用,并将LAAC与当前的最佳实践进行比较.
- 通过皮肤和手术进行的LAAC对降低心房动中风风险具有显著的希望.
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