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左心房尾闭塞研究III-子子研究
Kevin S Kim1, Emilie P Belley-Côté2, Michael Walsh2
1Department of Health Research Methodology, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada; Perioperative and Surgery Research Program, Population Health Research Institute, Hamilton, Ontario, Canada.
American heart journal
|April 21, 2025
概括
左心房尾阻塞有效降低心房动和慢性病患者中风风险. 这种程序在不同的功能水平上显示出一致的好处,而不会增加不良事件.
科学领域:
- 心脏病学 心脏病学
- 腎臟病學 (nephrology) 是一種醫學專業.
- 医疗器械 医疗器械
背景情况:
- 慢性病 (CKD) 患者心房动 (AF) 的最佳抗凝药仍然不清楚.
- 左心房附属物阻塞 (LAAO) 的疗效在CKD患者中可能有所不同.
- 这项研究是对LAAOS III试验的二次分析.
研究的目的:
- 研究LAAO对AF和不同程度的功能患者中风风险和安全结果的影响.
- 为了确定基线功能是否影响LAAO的有效性.
主要方法:
- 对LAAOS III试验 (NCT01516151) 的二次分析,该试验涉及4768名接受心脏手术的AF参与者.
- 估计的淋巴膜过率 (eGFR) 使用CKD-EPI 2021方程计算.
- 考克斯比例危险模型用于评估LAAO影响,功能作为连续和分类变量.
主要成果:
- 与没有闭塞相比,LAAO与中风风险的显著降低有关 (HR 0.67;P = .001),不论eGFR.
- 两组之间在全因死亡率,心血管疾病死亡,心力衰竭住院,严重出血或心肌梗塞方面没有发现显著差异.
- 对于任何结果,eGFR和LAAO之间没有显著的相互作用.
结论:
- 手术LAAO在降低AF患者中风风险方面表现出一致的有效性,AF患者的功能受损.
- LAAO是预防中风的安全替代方案,用于患有CKD的AF患者,而不会增加重大不良事件的风险.
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