在接受维生素K抗剂的患者中,长期左心室血栓的解决:多中心观察性研究
Emanuele Valeriani1,2, Giulia Astorri3, Arianna Pannunzio4,3
1Department of General Surgery and Surgical Specialty Paride Stefanini, Sapienza University of Rome, Rome, Italy. emanuele.valeriani@uniroma1.it.
Internal and emergency medicine
|April 3, 2025
概括
在左心室血栓形成 (LVT) 中使用维生素K对抗剂治疗长达12个月,显示70%的解决率. 较低的射出分数和动脉瘤与LVT分辨率降低有关,事件发生率低.
科学领域:
- 心脏病学 心脏病学
- 血栓形成研究研究
- 药物治疗 药物治疗
背景情况:
- 左心室血栓塞 (LVT) 构成血栓栓塞事件的重大风险.
- 对LVT抗凝药治疗的最佳持续时间仍未完全确定.
- 维生素K抗体 (VKAs) 是LVT的常见治疗方式.
研究的目的:
- 评估维生素K抗剂 (VKA) 治疗在左心室血栓塞 (LVT) 患者中长达12个月的有效性和安全性.
- 为了确定VKA治疗期间LVT分辨率和相关的血栓栓塞或出血事件的累积发病率.
主要方法:
- 追溯队列研究,包括90名在2011年至2023年期间被诊断患有LVT的患者.
- 患者接受VKA治疗,直到LVT解决或最长为12个月.
- 评估的结果包括LVT分辨率,急性缺血性中风,心肌梗塞,外周栓塞和出血事件.
主要成果:
- 在12个月内,LVT解决的累积发病率为70% (95% CI,60%-79%).
- 减少左心室喷射率和左心室动脉瘤与较低的LVT分辨率相关 (HR分别为0.48和0.44).
- 观察到在治疗期间发生的动脉事件 (1次中风,1次心脏病发作) 和出血事件 (2次重大,4次非重大) 的比例较低.
结论:
- 长达12个月的维生素K抗剂治疗似乎有效实现LVT解决.
- 降低左心室功能和动脉瘤的存在是LVT解决的负面预测因素.
- 在这个队列中,VKA治疗的安全性概况是有利的,血栓栓塞和出血并发症的发病率很低.
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