在HeartMate 3左心室辅助器件中Apixaban的安全性和有效性
Ashwin A Pillai1,2, Aryan Mehta1,2, Balaphanidhar Mogga2
1University of Connecticut, Farmington, Connecticut, USA.
Clinical transplantation
|January 6, 2026
概括
阿皮克萨班显示承诺作为一个安全的替代品华法林为HeartMate 3左心室辅助器件 (LVAD) 患者. 它显著降低了早期严重出血的风险,并改善了血液相容性,而不会增加血栓事件.
科学领域:
- 心脏病学 心脏病学
- 医疗器械 医疗器械
- 药理学 药理学是指药理学的学科.
背景情况:
- 华法林是左心室辅助器件 (LVAD) 的标准抗凝剂,但由于其狭窄的治疗指数和药物相互作用,它存在挑战.
- 低于最佳的抗凝剂增加了LVAD患者血栓和出血并发症的风险.
研究的目的:
- 评估阿皮克萨班作为HeartMate 3 (HM3) LVAD患者的替代抗凝剂的安全性和有效性.
- 为了在这个患者群体中比较华法林和阿皮克萨班之间的出血和血栓事件.
主要方法:
- 从2018年至2024年对47名患有HM3 LVAD的患者进行了回顾性分析.
- 华法林治疗患者和过渡到阿皮克萨班治疗的患者之间的血栓栓塞和出血事件的比较.
主要成果:
- 阿皮克萨班在前3个月内显著降低了严重出血的相对风险 (RR 0.08,p=0.01).
- 所有原因的出血发生在阿皮克萨班较少 (32%对68.8%,RR 0.14,p=0.009).
- 使用阿皮克萨班与改善的血红相容性有关,由血红蛋白增加和乳酸脱酶水平降低表明;血栓事件在两组之间是相似的.
结论:
- 阿皮克萨班可以作为HM3 LVADs患者的安全有效的替代抗凝剂.
- 这些发现表明,在减少出血并发症和改善血红相容性方面,有潜在的益处.
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