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对HeartMate 3左心室辅助器件进行保守的内沙林桥梁协议的影响
Sean McKee1,2, Kelsey Brebberman1, Gregory F Egnaczyk3
1From the Department of Pharmacy, The Christ Hospital Health Network, Cincinnati, Ohio.
概括
对于具有次治疗性国际正常化比率 (INR) 和HeartMate 3设备的患者,一种保守的埃诺沙巴林桥梁协议可能会减少重大出血事件. 这种方法可能比常规桥梁更安全,可能会避免这种患者群体的伤害.
科学领域:
- 心脏病学 心脏病学
- 医疗器械 医疗器械
- 药理学 药理学是指药理学的学科.
背景情况:
- 在使用左心室辅助器件 (LVAD) 的患者中,次治疗国际规范化比率 (INR) 需要管理.
- 目前在LVAD患者中治疗次级INR的桥梁协议尚未得到充分研究,可能会带来风险.
研究的目的:
- 评估一项保守的埃诺沙巴林桥梁协议是否能减少心脏Mate 3 (HM3) 设备接收者与次治疗INRs的主要出血和血栓事件.
- 在LVAD患者中评估修改过桥策略的安全性和有效性.
主要方法:
- 回顾性,单中心,前后队列研究设计.
- 包括82名患者和237次次治疗INR发作.
- 历史对照组和用保守的素桥梁协议管理的组之间的结果比较.
主要成果:
- 在30天内发生重大出血或血栓事件的二次综合结果在协议实施后显著减少 (10.5%对3.8%,p = 0.041).
- 30天内主要出血事件显著减少 (10.5%对3.0%,p = 0.019).
- 在接受抗血小板治疗的患者中,初级复合结局在后协议组显著下降 (5.1%对比0.0%,p=0.044).
结论:
- 在HM3患者中,针对次治疗INR的常规桥梁可能是不必要的,可能是有害的.
- 保守的埃诺沙巴林桥梁协议可以减少重大出血事件而不会增加血栓事件.
- 需要对更大规模的研究进行进一步的研究来验证这些发现.
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