单独抗凝药与抗凝药加上阿司匹林或DAPT 随着左心室尾闭塞
Samuel W Reinhardt1, Douglas N Gibson2, Jonathan C Hsu3
1Section of Cardiovascular Medicine, Yale University School of Medicine, New Haven, Connecticut, USA.
Journal of the American College of Cardiology
|August 28, 2024
概括
用Watchman FLX设备对左心房附属体封闭 (LAAO) 后的抗血栓策略进行了评估. 单独的DOAC或单独的华法林显示的不良事件比DOAC加阿司匹林少.
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:
- 左心房附属体封闭后 (LAAO) 的抗血栓策略缺乏全面的描述.
- 了解不同抗血栓治疗方案的结果对于患者护理至关重要.
研究的目的:
- 用Watchman FLX设备分析LAAO后出院时的真实世界抗血栓药物治疗模式.
- 为了比较与各种抗血栓策略相关的不良事件的风险.
主要方法:
- 分析了来自NCDR LAAO注册表 (2020-2022) 的53878名患者,他们使用第二代设备进行了LAAO.
- 患者根据排泄的抗血栓策略进行分类.
- 多变量考克斯回归被用来比较45天和6个月的不良事件率.
主要成果:
- 直接口服抗凝剂 (DOAC) 加上阿司匹林是最常见的治疗方案 (48.3%).
- 单独使用DOAC与45天和6个月的DOAC加阿司匹林相比,主要不良事件和严重出血的发生率明显较低.
- 华法林单独也显示大出血率有所降低.
结论:
- 在美国的现实实践中,使用单独的DOAC或单独的华法林在LAAO后与Watchman FLX设备一起使用,与使用DOAC加阿司匹林相比,与较少的不良事件有关.
- 这些发现支持优化LAAO后的抗血栓治疗.
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