在左心室辅助器件中直接口服抗凝剂:我们现在在哪里?
Leticia Blazquez-Arroyo1, Guglielmo Gallone2, Luca Baldetti3
1Department of Anesthesia, Cardiology and Critical Care, Royal Brompton & Harefield Hospitals, Guy's & St. Thomas' NHS Foundation Trust, London, UK.
概括
像阿皮克萨班这样的直接口服抗凝剂在HeartMate 3左心室辅助器件 (LVAD) 患者中显示出降低出血的潜力. 需要进一步的研究来优化它们的使用,并确认安全性和有效性.
科学领域:
- 心脏病学 心脏病学
- 生物医学工程 生物医学工程
- 药理学 药理学是指药理学的学科.
背景情况:
- 左心室辅助器械 (LVADs),特别是HeartMate 3,由于抗凝血需求而面临出血并发症的挑战.
- 直接口服抗凝剂 (DOAC) 与传统抗凝剂 (如维生素K抗剂 (VKA)) 相比,具有潜在的优势.
研究的目的:
- 审查目前关于在HeartMate 3 LVAD患者中使用DOAC,特别是apixaban的证据.
- 提供实用指导,并确定在LVAD治疗中DOAC抗凝剂的研究缺口.
主要方法:
- 对HeartMate 3 LVAD受体中DOACs (apixaban) 的现有文献进行系统审查.
- 综合有关疗效,安全性,剂量和患者选择的数据.
主要成果:
- 阿皮克萨班是对HeartMate 3患者研究最多的DOAC,显示出降低出血风险的潜力.
- 目前的证据受限于小样本规模和短的随访时间.
- 在心脏移植候选人等特定子组的最佳剂量,启动时间,监测和安全性方面存在差距.
结论:
- 在选择的HeartMate 3 LVAD患者中,阿皮克萨班为VKAs提供了一个有前途的替代品,用于抗凝.
- 需要更多的研究来制定最终的指导方针,并扩大DOAC在LVAD治疗中的作用.
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