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早期与晚期抗凝剂在急性缺血性中风中用于非心房的指示

Ming May Zhang¹, Fady Mousa-Ibrahim¹, Nicole A Leshko¹

¹Northwestern Memorial Hospital.

Research square

|July 29, 2024

概括

在急性缺血性中风 (AIS) 后,用于非心房 (AF) 指示的早期抗凝药是安全的,并且与更好的结果相关. 晚期抗凝剂增加了出血,复发性AIS和死亡的风险.

科学领域:

神经学神经学
心脏病学心脏病学
血液学血液学血液学

背景情况:

在急性缺血性中风 (AIS) 后,为心房动 (AF) 患者确立了抗凝时间.
有限的证据表明,在AIS后的非AF指示中,优化抗凝血启动是有限的.

研究的目的:

为了比较早期与晚期抗凝药的结果,在患有AIS和非AF的患者中.
评估与不同抗凝时间相关的重大出血和血栓事件的风险.

主要方法:

追溯队列研究比较早期 (≤4天) 与晚期 (5-14天) AIS后的抗凝血治疗.
主要结局:在30天内内内出血或主要外出血的组合.
二次结局:主要出血,复发性AIS,全身栓塞和30天内全因死亡率的组合.

主要成果:

分析了81名患者;早期65名,晚期16名抗凝血队列.
主要组合结局发生在4.6% (早期) 和12.5% (晚期) (p=0.255) 的患者中.
二次综合结局发生在15.4% (早期) 和43.8% (晚期) (p=0.034),由复发性AIS和死亡率驱动.

结论:

早期抗凝药 (≤4天) 后AIS非AF指示没有增加重大出血风险.
晚期抗凝药 (5-14天) 与出血,血栓事件和死亡率的综合风险增加有关.
需要进一步的研究来确定这个人群中最佳的抗凝血时间.

关键词:

这是一种抗凝血药物.血流性中风血流性中风缺血性中风中风

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