长期作用的XI因子抑制和周围流程出血:来自AZALEA-TIMI 71的分析
Siddharth M Patel1, Robert P Giugliano1, David A Morrow1
1TIMI Study Group, Division of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Journal of the American College of Cardiology
|June 11, 2025
概括
作为一种新型长效XI因子抑制剂的阿贝拉西马布在接受侵入性手术的心房患者中显示出较低的周围手术出血率. 对于XI因子的抑制,可能不需要常规的抗凝中断,特别是在低风险的手术中.
科学领域:
- 心血管医学 心血管医学
- 药理学 药理学是指药理学的学科.
- 血液学 血液学 血液学
背景情况:
- 心房动 (AF) 患者通常需要抗凝药来预防中风.
- 新型抗凝血剂正在开发中,以提高安全性.
- 阿贝拉西马布是一种长效的XI因子抑制剂,其半衰期约为28天.
研究的目的:
- 在接受abelacimab的心房动患者中评估周围手术出血.
- 在长效XI因子抑制下进行侵入性手术时评估安全结果.
主要方法:
- 在AZALEA-TIMI 71试验中,患者被随机分配给abelacimab (每月90或150毫克) 或rivaroxaban (每天).
- 术周出血 (主要/CRNM) 在侵袭性手术后30天内进行评估.
- 程序根据出血风险 (低,中等,高) 分类.
主要成果:
- 观察到周围手术主要或临床相关非主要 (CRNM) 出血率较低 (<2%的手术).
- 阿贝拉西马布手臂的出血率为1.2%,而里瓦洛克萨班手臂的出血率为2.2%.
- 在abelacimab服用后30天内,只有0.9%的手术导致重大/CRNM出血.
结论:
- 接受abelacimab治疗的AF患者可以接受具有低出血风险的侵入性手术.
- 在所有使用XI因子抑制剂的手术中,可能不需要常规中断抗凝药.
- 这些发现支持abelacimab在需要侵入性干预的患者中的安全性.
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