早期出血对左心房尾闭塞后的长期死亡率的影响
Gerardo V Lo Russo1, Abdalla Kara Balla2, Hasan S Alarouri2
1Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota; Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy.
Heart rhythm
|July 20, 2024
概括
在接受左心房尾闭塞 (LAAO) 的七分之一的患者经历了早期出血,这与死亡率的增加有关. 识别出血预测因子对于管理LAAO后患者至关重要.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 医疗器械研究 医疗器械研究
背景情况:
- 短期抗血栓治疗是标准的后左心房尾闭塞 (LAAO) 预防器件血栓形成.
- 接受LAAO的患者往往有高出血风险,但早期出血事件的了解很少.
研究的目的:
- 为了确定LAAO后早期出血的发生率.
- 评估早期出血与长期死亡率之间的关联.
- 为了确定LAAO患者早期出血的预测因素.
主要方法:
- 在梅奥诊所 (2018-2023) 接受LAAO治疗的592名患者的回顾性分析.
- 早期出血定义为出院后3个月内发生的事件.
- 用于评估死亡风险和出血预测指标的多变量Cox模型和回归分析.
主要成果:
- 14.0%的患者出现了早期出血,大多是最小的或轻微的.
- 早期出血与全因死亡风险增加2倍相关 (aHR 2.07).
- 预测因素包括先前的内出血,非宫性心房动,CHA2DS2-VASc得分和早期器件血栓.
结论:
- 在LAAO后90天内,大约14%的患者出现非程序性出血.
- 在LAAO后的早期出血是中期所有原因死亡率的重要风险因素.
- 优化对LAAO患者的抗血栓治疗策略需要进一步调查.
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