直接口服抗凝药与对抗左心室血栓的华法林
Joseph Kassab1, Joseph Hajj2, Rishi Puri2
1Department of Internal Medicine, UT Southwestern Medical Center, Dallas, TX 75390, USA.
European heart journal open
|January 15, 2026
概括
与华法林相比,直接口服抗凝剂 (DOAC) 在治疗左心室 (LV) 血栓方面表现出类似的有效性和安全性. 这项研究支持DOAC作为LV血栓可行的替代治疗方法.
科学领域:
- 心脏病学 心脏病学
- 药理学 药理学是指药理学的学科.
- 临床研究 临床研究
背景情况:
- 左心室 (LV) 血栓与显著的死亡率和栓塞风险有关.
- 华法林一直是传统的治疗方法,但与直接口服抗凝剂 (DOAC) 的比较数据有限.
研究的目的:
- 在被诊断为LV血栓的患者中,将DOAC与华法林的实际风险调整结果进行比较.
- 评估这些抗凝固疗法在特定患者群体中的有效性和安全性.
主要方法:
- 从2016年至2022年,对成年患有心声学证实LV血栓的成年患者进行回顾性队列分析.
- 倾向性得分匹配 (1:1) 用于平衡DOAC和华法林组之间的基线特征.
- 排除标准包括心房动,先前的静脉血栓栓塞和机械.
主要成果:
- 在DOAC和华法林组之间,30天和1年后所有原因死亡率和中风/暂时性缺血性发作的复合结果没有显著差异.
- 在30天和1年后的两组治疗中,主要出血率在两组治疗中都是可比的.
- 大约81%的患者在6个月内实现了LV血栓解脱,根据使用的抗凝剂没有观察到显著差异.
结论:
- 直接口服抗凝剂 (DOAC) 和华法林在治疗左心室血栓方面表现出可比的疗效和安全性.
- 在LV血栓患者中,DOACs是华法林的合理和有效替代品.
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