左心房附属体闭塞的三年临床结果,包括或不包括切除:来自RECORD研究的见解
Tingting Zhang1, Xueni He1, Guotao Fu2
1Department of Cardiology, Xijing Hospital, Fourth Military Medical University, Xi'an, China.
概括
与LAAO单独相比,左心房尾封闭 (LAAO) 加上切除可显著减少心血管死亡,中风和全身血栓塞.在三年内. 这种组合疗法为心房的管理提供了一个有希望的策略.
科学领域:
- 心脏病学 心脏病学
- 医疗器械 医疗器械
- 电力生理学 电力生理学
背景情况:
- 关于左心房尾闭塞 (LAAO) 结合心房动的移除术的长期疗效仍在争论中.
- 在RECORD研究中,研究了LAAO的三年后的结果,包括或不包括并发性切除.
研究的目的:
- 为了比较接受LAAO单独治疗的患者的临床结果与LAAO加一阶段切除的患者.
- 在这些患者群体中评估三年内心血管死亡,中风和全身栓塞的发病率.
主要方法:
- 一个前性注册表 (RECORD研究) 招募了3082名接受WATCHMAN LAAO设备的患者.
- 使用1:1的倾向分数匹配来比较LAAO-only和LAAO加上去除组之间的结果.
- 主要终点是三年内心血管死亡,中风和全身栓塞的复合.
主要成果:
- 在匹配后,每个组中有1,016名患者 (仅LAAO与LAAO加上切除).
- LAAO加上去除显示复合终点的风险明显较低 (6.9%与10.4%,HRPSM:0.66,p=0.007).
- 这种降低主要是由于心血管死亡风险较低 (3.7%对7.3%,HRPSM:0.50,p=0.001).
结论:
- 与LAAO单独相比,LAAO加上消化疗法在三年内显示了较大心血管不良事件的风险降低.
- 这些发现表明,在精选的心房动患者中,将LAAO与切除结合起来,可能会有潜在的益处.
- 鉴于观察设计,结果被认为是产生假设的,需要进一步调查.
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