在植入了连续流动左心室辅助器件的患者中,沙的安全性
Rachel C Klosko1, Bryan Whitson2, Brent Lampert3
1Department of Pharmacy Practice, Binghamton University School of Pharmacy and Pharmaceutical Sciences, Johnson City, New York, USA.
Artificial organs
|November 27, 2024
概括
埃诺沙巴林 (LMWH) 和未分离的肝素 (IV UFH) 在连续流动左心室辅助器件 (CF-LVAD) 患者中显示出类似的重大出血和血栓栓事件的发生率. 轻微出血在IVUFH中更为频繁.
科学领域:
- 心脏病学 心脏病学
- 生物医学工程 生物医学工程
- 药理学 药理学是指药理学的学科.
背景情况:
- 持续流动的左心室辅助器件 (CF-LVADs) 对于心力衰竭管理至关重要.
- 在CF-LVAD患者中管理抗凝血,在华法林上具有次治疗INR的患者面临挑战.
- 埃诺沙巴林 (LMWH) 和静脉注射未分离的肝素 (IV UFH) 用于桥梁抗凝药.
研究的目的:
- 为了比较主要出血事件的发生率.
- 为了评估血栓栓塞事件.
- 在CF-LVAD患者中评估抗凝血策略 (LMWH vs. IV UFH),这些患者在华法林治疗中具有次治疗INR.
主要方法:
- 在单个中心进行回顾性队列研究.
- 包括在2012年1月至2020年7月期间植入CF-LVAD的患者.
- 分析了在植入后至少60天接受LMWH或IV UFH的患者.
主要成果:
- 在重大出血 (2.5% LMWH vs 10.0% IV UFH; p=0.36) 或血栓塞栓事件 (7.5% LMWH vs 2.5% IV UFH; p=0.62) 中没有显著差异.
- 在每组中都发生了一次致命的血栓栓塞事件.
- 在IVUH组中,轻微出血更频繁 (25.0%对7.5%;p=0.03).
结论:
- 在CF-LVAD患者中,LMWH和IV UFH在重大出血和血栓塞栓事件方面表现出可比的安全性.
- 需要进一步的前性随机试验来证实这些发现.
- 抗凝药的选择可能取决于特定的患者因素和出血风险.
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