穿皮左心房附属体封闭对缺血性中风严重性的影响
Ahmed Maraey1, Hadeer Elsharnoby2, Mona Mahmoud1
1Division of Cardiovascular Medicine, University of Toledo Medical Center, Toledo, OH, United States of America.
概括
与抗凝药相比,穿皮左心房尾闭塞 (pLAAO) 在心房患者中减少了严重和致命的缺血性中风. 这一发现表明pLAAO可能会改善中风后果的保护.
科学领域:
- 心脏病学 心脏病学
- 神经学 神经学
- 医疗器械 医疗器械
背景情况:
- 穿皮左心房尾闭塞 (pLAAO) 是抗凝药 (AC) 的替代方案,用于预防高出血风险的心房动 (Afib) 患者中风.
- pLAAO显示,残疾性中风的发生率有所降低,主要是由于出血性中风的减少.
- 对于pLAAO对缺血性中风严重性的影响仍未得到充分研究.
研究的目的:
- 为了研究pLAAO对心房动患者缺血性中风 (IS) 严重性的影响.
- 为了比较用pLAAO治疗的患者与AC治疗的患者的IS结果.
主要方法:
- 国家再接收数据库 (2016-2020年) 的回顾性分析.
- 在pLAAO后确定了IS的6个月复发,并与因IS入院的AC上Afib患者进行比较.
- 使用的倾向评分与混因子对照相匹配;排除了脑内出血或手术LAAO的患者.
主要成果:
- 匹配分析包括每组342个观察结果 (加权:583个pLAAO与663个AC).
- pLAAO与致命性中风风险显著降低有关 (5.1%与10.0%,或0.48,P=0.018).
- pLAAO还显示,在6个月后,非致命的严重中风风险降低 (50.5%与59.6%,或0.69,P=0.029).
结论:
- 与AC患者相比,经历了缺血性中风的pLAAO患者的严重和致命结局的可能性较低.
- 这些发现表明,PLAAO可能会提供对严重中风后果的优越保护.
- 需要进一步的研究来证实这些结果.
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