JACC:经导管主动脉瓣置换术后阿司匹林与阿司匹林加氯吡格雷抗血栓治疗的比较

2017-07-04 xiangting MedSci原创

这项小型试验显示,SAPT(vs.DAPT)能减少TAVR后主要不良事件的发生。

这项研究的目的是比较为预防缺血事件、出血和死亡,经导管主动脉瓣置换术(TAVR)后,使用阿司匹林加氯吡格雷或单独使用阿司匹林抗血栓的疗效。

关于TAVR后最佳抗血栓治疗的数据很少见。这是一项随机对照试验,比较接受球囊扩张瓣TAVR患者阿司匹林(80至100mg/天)加氯吡格雷(75 mg/天)(双重抗血小板治疗[DAPT])与单独使用阿司匹林(单抗血小板治疗[SAPT])的效果。主要终点是术后3个月内死亡、心肌梗死(MI)、中风或短暂性脑缺血发作,或重大或危及生命的出血(根据瓣研究协会2定义)的发生。在纳入了74%的计划研究人群后,试验提前终止。

共纳入222例患者,111例分配到DAPT,111例分配到SAPT。死亡,心肌梗死,中风或短暂性脑缺血发作,或重大或危及生命的出血的综合在DAPT组发生更频繁(15.3%vs. 7.2%,p = 0.065)。3个月时组间死亡(DAPT,6.3%; SAPT,3.6%; p = 0.37),MI(DAPT,3.6%; SAT,0.9%; p = 0.18)或中风或短暂性脑缺血发作(DAPT,2.7%; SAPT,0.9%; p = 0.31)发生率无差别。DAPT与重大或危及生命的出血事件发生率高相关(10.8%vs 3.6%,p = 0.038)。TAVR后组间血流动力学状态无统计学差异。

这项小型试验显示,SAPT(vs.DAPT)能减少TAVR后主要不良事件的发生。SAPT降低了重大或危及生命事件的风险,并不增加MI或中风的风险。需要更大样本的研究来确认这些结果。

原始出处:

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    2017-12-28 yxch48
  2. 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    2017-12-24 hbwxf
  3. 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    2017-07-14 大爰

    学习了增加知识了分享了谢谢!

    0

  4. 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    2017-07-06 maymoon1983

    学习了 谢谢分享

    0

  5. 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    2017-07-06 lsj631

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EUR HEART J:5年的临床和超声心动图的研究结果表明经导管主动脉瓣移植(TAVI)自我扩张型人工瓣膜可用于治疗严重的主动脉瓣狭窄!

在现实生活中,有症状且主动脉瓣高度狭窄的患者进行瓣膜置换术手术风险很高,该研究的目的是评估经导管主动脉瓣移植(TAVI)自我扩张型人工瓣膜的安全性和有效性。

EUR HEART J:使用全新一代气囊可膨胀心脏瓣膜,经导管主动脉瓣移植后的1年结果

使用最新一代气囊可膨胀心脏瓣膜,经导管主动脉瓣移植后的1年结果

JACC:经导管主动脉瓣置换治疗二瓣叶与三瓣叶主动脉瓣狭窄的比较

与三瓣叶AS相比,二瓣叶AS的TAVR预后相似,但装置成功率较低。在用早期器械治疗的患者中观察到手术结果差异,而在新一代装置没有观察到差异。

JACC:经导管主动脉瓣置换的手术经验及其与结局的关联

在美国引入TAVR进入临床的初始阶段显示,经验增加与更好的结局相关。