大型缺血性中风后早期抗凝剂在心血管栓塞性中风后抗凝剂的开始研究研究
Jayachandra Muppa1, Shadi Yaghi2, Liqi Shu2
1Department of Neurology, University of Massachusetts Chan Medical School, Worcester, MA, USA.
Journal of clinical neurology (Seoul, Korea)
|October 28, 2025
概括
大型缺血性中风后的早期抗凝药是安全的,在现实数据中显示大出血风险低,没有复发性缺血性中风. 这一发现支持对大脑中风患者及时启动治疗.
科学领域:
- 神经学 神经学
- 心脏病学 心脏病学
- 临床试验 临床试验
背景情况:
- 有限的现实世界的数据存在于早期抗凝血安全性在大型缺血性中风.
- 临床试验表明一般安全性,但大型中风数据很少.
研究的目的:
- 评估抗凝药启动时间和90天内复发性缺血和重大出血事件的风险之间的关联.
- 在患有大缺血性中风 (体积≥60毫升) 的患者中评估早期抗凝安全性.
主要方法:
- 在心血管血栓性中风 (IAC) 后启动抗凝剂研究中的连续患者的分析.
- 评估复发性缺血事件,重大出血事件 (症状性内出血[sICH],重大外出血[ECH]) 和90天内的综合结果.
主要成果:
- 包括155名患者;总共发生了11起事件 (4例缺血病,2例SICH,5例主要ECH).
- 对于复发性缺血性或出血性事件,抗凝时间没有显著差异.
- 在7天内服用抗凝剂的患者中没有发生过缺血性事件;后来只发生了一次SICH.
结论:
- 在大缺血性中风 (IAC研究) 中早期的抗凝剂表明sICH的风险较低.
- 在这个队列中,没有观察到在早期抗凝药时出现复发性缺血性中风.
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