患有心房高频发作 (AHREs) 的患者的抗血栓治疗:当前的证据和开放问题
Vincenzo De Sio1, Felice Gragnano1, Antonio Capolongo1
1Department of Translational Medical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy; Division of Cardiology, A.O.R.N. "Sant'Anna e San Sebastiano", Caserta, Italy.
International journal of cardiology
|December 21, 2024
概括
通过心脏器件检测到的无症状心房律不整,例如心房高频发作 (AHREs),与心血管风险增加有关. 目前的证据不支持针对AHREs或亚临床心房动 (SCAF) 的常规抗凝剂使用.
科学领域:
- 心脏病学 心脏病学
- 电力生理学 电力生理学
- 医疗器械技术 医疗器械技术
背景情况:
- 心脏电子植入式器件经常检测无症状心房律乱,如心房高频发作 (AHREs) 和亚临床心房动 (SCAF).
- AHREs被认为是明显心房动 (AF) 的潜在前体,并与心血管事件风险增加有关.
研究的目的:
- 审查和综合有关AHREs和设备检测SCAF的临床影响的现有证据.
- 为了确定这些亚临床心律不整的患者的风险分层和管理策略的差距.
主要方法:
- 对AHREs和设备检测SCAF的现有文献进行系统审查.
- 关于与血栓栓塞事件和心血管结果相关的证据的评估.
- 评估当前的指导方针和正在进行的关于抗凝药治疗的辩论.
主要成果:
- AHREs和SCAF与血栓栓塞事件和主要心血管事件的风险增加有关,包括心肌梗塞和心力衰竭.
- 尽管存在这些风险,但目前不建议在患有AHREs或SCAF的患者中进行常规抗凝剂治疗.
- 脑卒中风险和AHREs之间的关系,以及抗凝剂的潜在益处,仍然是积极研究和辩论的领域.
结论:
- 患有AHREs/SCAF的患者面临心血管不良结果的风险增加,需要进一步研究有效的风险分层.
- 对AHREs/SCAF的临床管理,特别是抗凝剂的作用,需要进一步研究以指导治疗决策.
- 正在进行的研究至关重要,以澄清亚临床心房失常症的预后意义和最佳治疗策略.
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