皮肤穿透左心室尾关闭后的抗血栓治疗:来自TERMINATOR注册表的结果
Yoichi Sugiyama1, Takashi Matsumoto1, Shunsuke Kubo2
1Department of Cardiology and Catheterization Laboratories, Shonan Kamakura General Hospital, Kamakura, Japan.
JACC. Asia
|January 7, 2026
概括
在接受左心房尾关闭 (LAAC) 的日本患者中,最初的抗血栓治疗方案差异很大. 不同的LAAC后抗血栓策略在短期内没有显著影响重大不良事件.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 抗血栓性治疗是一种抗血栓性疗法.
背景情况:
- 穿皮左心房尾关闭 (LAAC) 是抗凝药的替代方案,用于预防非膜性心房的中风.
- 华法林加阿司匹林,虽然建议,但在LAAC后并不普遍使用;直接口服抗凝剂 (DOAC) 和其他方案在现实实践中很常见.
- 在LAAC之后,最佳的抗血栓策略,特别是在具有明显出血和缺血风险概况的亚洲人群中,需要进一步调查.
研究的目的:
- 为了检查在日本现实世界注册表中,在LAAC后处方的抗血栓治疗方案的多样性.
- 评估不同抗血栓策略与LAAC后6个月的主要不良事件之间的关联.
主要方法:
- 在日本多中心观察注册表中分析了在2019年8月至2023年5月期间接受LAAC治疗的1449名患者.
- 在出院时对抗血栓治疗方案的评估和发生在6个月内的主要不良事件.
- 倾向性得分调整用于减轻混因素,在比较不同方案的结果时.
主要成果:
- 最常见的排泄抗血栓治疗方案包括DOAC (32.4%),DOAC和阿司匹林 (30.3%),华法林和阿司匹林 (13.7%).
- 其他治疗方案包括DOAC和P2Y12抑制剂 (10.4%) 和仅华法林 (6.2%).
- 在对共变量进行调整后,抗血栓治疗方案的变化与6个月的主要不良事件的差异没有显著联系.
结论:
- 来自日本的真实世界数据表明,在LAAC之后的初始抗血栓治疗中存在相当大的变化.
- 初始抗血栓治疗方案的选择并没有对该患者队列的短期临床结果产生显著影响.
- 进一步的研究是有必要的,以建立最佳的抗血栓策略后LAAC,考虑到区域和种族差异.
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