在等待左耳前关闭的患者中,不良事件的发生率和预测因素
Justin Pieper1, Sapan Bhuta1, Michael Poliner1
1Electrophysiology Section, Division of Cardiovascular Medicine, Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
Journal of cardiovascular electrophysiology
|December 10, 2024
概括
左心房关闭 (LAAC) 的延迟增加了不良事件的风险. 高HAS-BLED分数也预测并发症,为高风险患者提供加速程序.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 医疗器械技术 医疗器械技术
背景情况:
- 关于左心室尾关闭 (LAAC) 的最佳时间存在有限的数据.
- 程序延迟对等待LAAC的患者不良结果的影响还不清楚.
研究的目的:
- 在接受LAAC的患者中确定不良事件的发生率和预测因素.
- 评估与LAAC之前的等待期相关的风险.
主要方法:
- 一个单一中心的回顾性研究分析了265名在2017年1月至2020年3月期间接受LAAC的患者.
- 从决定到程序的过程中追踪了不良事件 (出血,贫血,血栓栓塞,死亡).
- 多变量分析确定了不良事件的预测因素.
主要成果:
- 从决定到保险批准的中位时间为18天,从批准到LAAC的中位时间为44天.
- 6%的患者 (17/265) 经历了不良事件,主要是出血/贫血 (15例).
- 增加LAAC的时间 (OR 1.31) 和更高的HAS-BLED得分 (OR 1.67) 是不良事件的显著预测因素.
结论:
- 长期等待LAAC的时间与更高的不良事件风险有关.
- 较高的HAS-BLED分数也预测了LAAC等待期间的风险增加.
- 对于高风险个人,建议加快LAAC程序.
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