早期原血栓评估在与设备相关的血栓风险分层中的作用,在左心室附属物关闭后
Pedro Cepas-Guillén1, Mathieu Robichaud1, Gilles O Hara1
1Cardiology Department, Quebec Heart & Lung Institute, Laval University, Quebec City, Canada.
Structural heart : the journal of the Heart Team
|October 13, 2025
概括
在左心房附属体关闭 (LAAC) 后早期的前列血栓状况评估可以确定患有设备相关血栓 (DRT) 风险较低的患者. 这允许安全排除DRT,并可能降低抗血栓治疗的升级.
科学领域:
- 心脏病学 心脏病学
- 血栓形成研究研究
- 医疗设备创新 医疗设备创新
背景情况:
- 左心房尾关闭 (LAAC) 是预防非膜心房的患者中风的关键策略,不适合口服抗凝药.
- 在LAAC后,与器件相关的血栓 (DRT) 的风险和早期前血栓状况评估的有用性仍然不完全理解.
研究的目的:
- 调查早期LAAC后前血栓状况与DRT发生率之间的关联.
- 确定潜在的非侵入性标志物和预测DRT风险的值.
主要方法:
- 招募了147名没有口服抗凝药的LAAC患者.
- 凝血激活标志物 (前热血素片段1+2,热血素抗热血素III) 在基线和LAAC后7天被测量.
- 根据标记物变化,患者被分为低或高血栓状况;对DRT预测的值进行了评估.
主要成果:
- 36.1%的患者患有高血栓状况;DRT发生在总体6.1%,高风险组显著高 (15.1%对1.1%).
- 升高的LAAC后凝血标志物独立预测了DRT (aOR 13.84).
- 对前列血片段1+2 (74.11%) 和血抗血III (120.74%) 的提议值显示98.9%的负预测值,确定75.5%为低DRT风险.
结论:
- 早期凝血标记的评估有效地预测了LAAC后的DRT风险.
- 确定的门值作为可靠的非侵入性工具来排除DRT.
- 这些发现可能会促进早期的抗血栓性降级,并减少成像需求.
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