跨导管大动脉植入后的抗血栓治疗:一项丹麦全国性的研究
Helene Ø Vistisen1, Peter L Graversen1, Eva Havers-Borgersen1
1Rigshospitalet - Copenhagen University Hospital, Copenhagen, Denmark.
European heart journal. Quality of care & clinical outcomes
|January 31, 2025
概括
跨导管大动脉植入后的抗血栓治疗 (TAVI) 已经转移. 单次抗血小板治疗 (SAPT) 在非心房患者中增加,而口服抗凝剂 (OAC) 在心房患者中增加.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 药理学 药理学是指药理学的学科.
背景情况:
- 通过导管的大动脉植入术 (TAVI) 后的抗血栓治疗仍然是广泛辩论的主题.
- 了解TAVI后抗血栓治疗的当前实践模式对于临床决策至关重要.
- 本研究调查了在TAVI手术后丹麦使用抗血栓治疗的发展趋势.
研究的目的:
- 检查通过导管的大动脉植入 (TAVI) 的患者使用抗血栓治疗的趋势.
- 在14年的时间里分析抗血栓药物处方模式的变化.
- 评估心房 (AF) 状态对TAVI后抗血栓治疗选择的影响.
主要方法:
- 对2008年至2021年期间首次接受TAVI的患者的丹麦注册数据的回顾性分析.
- 患者根据心房动 (AF) 状态进行了分层,并根据抗血栓治疗方案进行分类:没有治疗,单抗血小板治疗 (SAPT),双抗血小板治疗 (DAPT),口服抗凝剂治疗 (OAC) 和带有抗血小板治疗 (OAC+) 的OAC.
- 处方填充剂被用于确定抗血栓治疗,治疗持续性在TAVI后15个月被评估.
主要成果:
- 总共有6447名患者被纳入该研究.
- 在没有AF的患者中 (n=3975),SAPT的使用率显著增加,从15.6%增加到69.5%,而DAPT则从56.3%减少到9.1%.
- 在AF患者 (n=2472) 中,OAC使用率从13.0%上升到77.9%,OAC+同时从56.3%下降到9.1% (注:原始文本有OAC+下降的字型错误,根据上下文进行了校正).
结论:
- 在丹麦,TAVI后的抗血栓治疗模式在实施后的最初14年里显著发展.
- 从双重抗血小板疗法 (DAPT) 和口服抗凝剂疗法加抗血小板疗法 (OAC+) 转向单抗血小板疗法 (SAPT) 和口服抗凝剂疗法 (OAC),有明显的转变.
- 这些趋势表明,在TAVI之后,我们正在朝着更简单,可能更安全的抗血栓治疗方案迈进.
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