密集型与非密集型抗血栓治疗对与设备相关的血栓在左心房附属器关闭后的影响
Philippe Garot1, Pedro Cepas-Guillén2, Eduardo Flores-Umanzor3
1Institut Cardiovasculaire Paris-Sud (ICPS), Hôpital Jacques Cartier, Ramsay-Santé, Massy, France.
Revista espanola de cardiologia (English ed.)
|December 7, 2024
概括
在左心房附属体关闭后 (LAAC) 植入低于最佳的设备会增加与设备相关的血栓 (DRT) 的风险. 最佳植入显示低DRT率,无论密集或非密集的抗血栓治疗 (AT).
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 血栓形成研究研究
背景情况:
- 在左心房关闭后 (LAAC) 最佳的抗血栓治疗 (AT) 仍在争论中.
- 设备相关的血栓 (DRT) 是LAAC后的一个重要并发症.
研究的目的:
- 评估强化与非强化AT对DRT发病率的影响.
- 根据LAAC设备植入的质量 (最佳与次优) 来评估这种影响.
主要方法:
- 分析了接受LAAC的1225名患者.
- 植入质量:最佳 (近端, <3mm泄漏) 和次优质 (远端, ≥3mm泄漏).
- AT策略:密集 (双重治疗) 与非密集 (单一或没有治疗).
主要成果:
- 低于最佳的植入与4.51倍的DRT风险增加有关 (P<.001).
- 在最佳植入中,DRT发生率为2.6% (密集的AT) 和3.7% (非密集的AT) (P=.38).
- 在非最佳植入中,DRT发生率为11.2% (密集的AT) 与15.5% (非密集的AT) (P=19).
结论:
- 低于最佳的LAAC设备植入是DRT的独立预测因素.
- 在最佳植入中,DRT率很低,在AT策略中相似.
- 需要进一步的随机试验来证实这些发现.
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