一个比标准强度更高的国际规范化比率目标,用于接受机械大动脉置换的患者,并具有额外的血栓风险因素:系统审查和元分析协议
Myung-Rho Kim1, Taha Shaikh1, Shawn Wang2
1Department of Internal Medicine, Kirk Kerkorian School of Medicine, University of Nevada, Las Vegas, Las Vegas, United States.
JMIR research protocols
|July 10, 2025
概括
本系统性审查评估了机械大动脉置换 (MAVR) 患者的国际正常化比率 (INR) 的更高目标和额外的风险因素. 它旨在优化抗凝治疗,平衡血栓形成预防和出血风险.
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.
- 临床研究方法论 临床研究方法论
背景情况:
- 机械动脉置换 (MAVR) 需要使用维生素K对抗剂进行终身抗凝治疗,以防止栓凝血.
- 目前的指导方针建议在没有危险因素的情况下使用INR 2.5对MAVR,在有额外的血栓栓塞风险的情况下使用INR 3.0.
- 在高风险MAVR患者中,最佳抗凝强度的证据仍然有限.
研究的目的:
- 系统地审查和元分析高强度INR目标 (>3.0) 与标准强度目标 (大约3.0) 的安全性和有效性. 2.5) 的情况.
- 评估患有MAVR和额外的血栓栓塞风险因素的患者的结果.
主要方法:
- 按照PRISMA 2020指南进行系统审查和元分析.
- 在PubMed,Embase和Cochrane图书馆的文献搜索2024年12月18日之前发表的研究.
- 包括接受华法林治疗的成人MAVR患者的RCT,队列和后续研究,按危险因素分层.
主要成果:
- 综合现有数据,比较高风险MAVR患者强化抗凝剂的风险和益处.
- 不同INR目标策略之间的血栓栓塞事件和出血并发症的定量比较.
- 计划数据分析和手稿准备时间为2025年7月至8月.
结论:
- 这一审查将为高风险MAVR患者的INR管理提供关键证据.
- 结果可能会为未来的抗凝治疗临床指南更新提供信息.
- 这项研究旨在优化预防血栓栓塞并最大限度地降低出血风险之间的平衡.
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