直接口服抗凝剂与维生素K对抗剂用于左心室血栓管理
Syed I Khalid1, Pranav Mirpuri2, Joanna M Roy1
1Department of Neurosurgery, University of Illinois at Chicago, Chicago, IL, USA.
Heart & lung : the journal of critical care
|July 24, 2025
概括
直接口服抗凝剂 (DOAC) 在治疗左心室血栓 (LVT) 方面表现出与维生素K对抗剂 (VKA) 相当的安全性. 这项研究发现,在LVT患者中,DOACs和VKAs之间的重大出血或中风事件没有显著差异.
科学领域:
- 心脏病学 心脏病学
- 药理学 药理学是指药理学的学科.
- 临床研究 临床研究
背景情况:
- 左心室血栓 (LVT) 管理通常涉及抗凝治疗.
- 直接口服抗凝剂 (DOAC) 和维生素K抗剂 (VKA) 是常见的抗凝剂选择.
- 在LVT管理中,对DOAC与VKA的比较安全数据至关重要.
研究的目的:
- 为了比较内出血 (ICH),缺血性中风,过渡性缺血性发作 (TIA) 和重大出血事件的发生率.
- 为了评估DOAC与VKA在LVT患者中的安全概况.
- 为了评估治疗开始后的12个月和24个月的结果.
主要方法:
- 对涉及3152名为LVT治疗的患者的索赔数据的回顾性分析.
- 根据年龄,性别和并发症,两个队伍的确切匹配.
- 卡普兰-梅尔法用于评估12个月和24个月初级结局 (ICH,缺血性中风,TIA,大出血) 的差异.
主要成果:
- 分析了一组匹配的336名患者 (每组168名).
- 在12个月内,DOAC和VKA组之间没有观察到ICH,缺血性中风,TIA或重大出血事件的发生率的统计学上显著差异.
- 在两个抗凝剂组之间24个月后也发现了类似的发现,这些不良事件没有显著差异.
结论:
- 直接口服抗凝剂 (DOAC) 似乎是对维生素K抗剂 (VKA) 的安全和有效替代品,用于左心室血栓 (LVT) 管理.
- 这些发现支持在临床实践中对LVT患者使用DOAC.
- 需要进一步的前性研究来证实这些安全性和有效性结果.
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