在跨导管大动脉植入过程中,口服抗凝药的延续与中断对血液静止功能的影响
Dirk Jan van Ginkel1, Hendrik Stragier2, Willem L Bor1
1Department of Cardiology, St. Antonius Hospital, Nieuwegein, The Netherlands.
Journal of thrombosis and haemostasis : JTH
|December 5, 2025
概括
在跨导管大动脉植入 (TAVI) 期间持续口服抗凝剂 (OAC) 适度降低了凝血和纤维溶解激活. 然而,它抑制了血栓生成,增加了出血风险,但没有影响血栓栓塞事件.
科学领域:
- 心脏病学 心脏病学
- 血液学 血液学 血液学
- 干预心脏病学 干预心脏病学
背景情况:
- 三分之一接受过导管大动脉植入 (TAVI) 的患者需要口服抗凝剂 (OAC).
- 以前的研究表明,持续使用OAC可能会减轻TAVI后高凝血.
研究的目的:
- 评估持续与中断OAC在TAVI期间对血液静止的影响.
- 评估周围手术凝血和纤维溶解功能.
主要方法:
- 随机对照试验比较OAC延续 (82名患者) 与中断 (85名患者).
- 在6个时间点收集的血样本.
- 血液静止通过凝血/血生成和凝血/纤维解析/血小板/内皮细胞生物标志物进行评估.
主要成果:
- 在TAVI后,OAC的延续显著降低了内源性血栓激素潜力 (ETP) 和内源性等离子体潜力.
- 在不同组中,前素片段1+2水平在不同组之间是相似的.
- 内皮和血小板激活的标记物不受OAC策略的影响.
结论:
- 在TAVI期间持续使用OAC适度降低了急性凝血和纤维溶解激活.
- 这种策略抑制了ETP,并与增加出血风险有关.
- 主要试验中没有观察到血栓栓塞风险的显著差异.
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