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血小板反应性与左心室辅助器件患者的血栓相关
David Mutschlechner1,2,3, Maximilian Tscharre4,5, Franziska Wittmann6
1Department of Internal Medicine I, Cardiology and Intensive Care Medicine, Landesklinikum Mistelbach-Gänserndorf, Mistelbach, Austria.
Research and practice in thrombosis and haemostasis
|October 11, 2024
概括
治疗时高的残留血小板反应率 (HRPR) 与左心室辅助器件 (LVAD) 患者的血栓症有关. 这一发现表明HRPR可能是一个关键的风险标志物,特别是对于HVAD设备接收者.
科学领域:
- 心脏病学 心脏病学
- 生物医学工程 生物医学工程
- 血液学 血液学 血液学
背景情况:
- 左心室辅助器件 (LVAD) 需要抗血栓治疗来预防器件血栓形成和血栓栓塞.
- 高治疗残留血小板反应率 (HRPR) 是心血管疾病中缺血事件的已知危险因素.
研究的目的:
- 确定稳定的LVAD患者中HRPR的患病率和临床意义.
- 调查HRPR与不良血栓或出血事件之间的关联.
主要方法:
- 一项为期2年的随访研究评估了62名LVAD患者 (HeartWare HVAD和HeartMate3) 的血栓,出血和死亡.
- 使用多电极聚合计测量了血小板聚合,将HRPR定义为可诱导酸 (AA) 聚合≥21AU.
- 可溶性P-选择因水平通过ELISA量化.
主要成果:
- 在46.8%的患者中检测到HRPR,与更高的血小板聚合 (AA,ADP,TRAP) 和可溶性P-选择素水平相关.
- 血栓发生在4.8%的患者中,仅限于HRPR患者,特别是HVAD接受者 (P=0.06).
- 出血并发症 (16.1%) 与特定的血小板反应模式没有显著联系.
结论:
- 血小板反应性,特别是HRPR,与LVAD患者的血栓症有关.
- HRPR可以作为血栓形成的有价值的风险标志物,特别是在使用HeartWare HVAD设备的患者中.
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