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在左心房附属体封闭后的抗血栓策略和DOAC剂量:一个网络元分析

Athanasios Samaras^1,2, Paschalis Karakasis², Athanasios Feidakis³

¹School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece.

European heart journal. Cardiovascular pharmacotherapy

|November 25, 2025

概括

直接口服抗凝剂 (DOACs) 是左心房尾闭塞 (LAAO) 后最安全和最有效的抗血栓策略. 低剂量的DOACs可能会进一步降低出血风险,而不会影响疗效.

科学领域:

心脏病学心脏病学
干预心脏病学干预心脏病学
药理学药理学是指药理学的学科.

背景情况:

最佳的抗血栓治疗后的左心房尾闭塞 (LAAO) 尚不清楚,平衡出血和凝血风险.
直接口服抗凝剂 (DOACs) 是有前途的,特别是在设备愈合期间的低剂量疗法.
需要网络元分析来比较各种策略.

研究的目的:

为了比较LAAO后不同抗血栓策略的疗效和安全性.
评估DOAC剂量在LAAO后抗血栓治疗中的作用.
确定预防血栓栓塞和出血的最佳策略.

主要方法:

系统审查和网络元分析 (NMA) 遵循科克兰和PRISMA指南.
包括随机对照试验 (RCT) 和对接受LAAO的患者的观察性研究.
分析结果包括严重出血,血栓栓塞,与设备相关的血栓,以及死亡率.

主要成果:

与其他疗法相比,DOAC显示出明显较低的重大出血率和全因死亡率.
低剂量的DOAC显示,与标准剂量的DOAC相比,可能降低大出血风险.
与单一抗血小板治疗和维生素K对抗剂以及SAPT相比,DOACs,特别是低剂量,减少了血栓栓塞和设备相关的血栓形成.

结论:

在LAAO之后,DOACs为抗血栓治疗提供了优越的安全性和有效性概况.
低剂量的DOACs可以在不影响有效性的情况下提供增强的降低出血风险.
需要进一步的研究来确认低剂量DOAC在临床实践中的最佳作用.

关键词:

抗血栓策略抗血栓策略 DOAC 剂量测定方法直接的口服抗凝剂直接的口服抗凝剂左心房附属体封闭的情况结果的结果.

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