抗凝治疗的变化与左心室血栓的相关解决或持续:来自LATTEE注册表的见解
Monika Gawałko1, Monika Budnik1, Piotr Scisło2
1First Department of Cardiology, Medical University of Warsaw, Warsaw, Poland; "Club 30", Polish Cardiac Society, Poland.
The American journal of cardiology
|October 24, 2025
概括
对心房动/左心房血栓患者的最佳抗凝剂尚不清楚. 转换为非VKA口服抗凝剂可能会改善血栓解脱,但需要进一步的随机试验.
科学领域:
- 心脏病学 心脏病学
- 血栓形成研究研究
- 药理学 药理学是指药理学的学科.
背景情况:
- 对于心房动/动 (AF/AFl) 患者与左心房血栓 (LAT) 患者的最佳抗凝药的证据有限.
- 目前的指导方针缺乏针对AF/AFl中LAT管理的具体建议.
- 了解抗凝剂在LAT溶解中的作用对于患者的治疗结果至关重要.
研究的目的:
- 评估抗凝血策略的变化.
- 评估AF/AFl患者的抗凝变化和LAT分辨率之间的关联.
- 为了确定LAT分辨率的潜在预测因素.
主要方法:
- 在13个中心对3109名AF/AFl患者进行跨食道心声扫描 (TEE) 的回顾性分析.
- 包括LAT患者在最初的TEE中,其中一小部分接受后续TEE.
- 在不同的抗凝血疗法 (VKA,NOAC,LMWH) 和切换策略中对LAT患病率的比较.
主要成果:
- 左心房血栓 (LAT) 在8.0%的患者中存在; 55%的随访TEE患者显示LAT分辨率.
- 从维生素K对抗剂 (VKAs) 转换为非VKA口服抗凝剂 (NOACs) 与较低的LAT患病率有关,而不是继续使用VKAs或转换为LMWH.
- 停用阿皮克萨班与LAT解决有关,而继续治疗显示持续的LAT.
结论:
- 左心房血栓 (LAT) 在超过一半的AF/AFl患者中随访后消失.
- 抗凝血的变化,特别是切换到NOACs,可能与LAT分辨率有关.
- 需要进一步的随机对照试验来证实这些发现并指导临床实践.
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