JACC:左心耳封堵术和直接口服抗凝剂在高风险房颤患者中的比较研究

2020-06-24 MedSci原创 MedSci原创

经皮左心耳闭合术(LAAC)在预防心房颤动(AF)相关卒中方面非劣于维生素K拮抗剂(VKAs)。然而,直接口服抗凝剂(DOACs)比VKAs具有更好的安全性,其对LAAC相关心血管和神经结局的影响尚不

经皮左心耳闭合术(LAAC)在预防心房颤动(AF)相关卒中方面非劣于维生素K拮抗剂(VKAs)。然而,直接口服抗凝剂(DOACs)比VKAs具有更好的安全性,其对LAAC相关血管和神经结局的影响尚不清楚。本研究的目的旨在评估和比较LAAC和DOACs对高风险房颤患者的影响。

本研究将一个高风险房颤队列(CHA2DS2-VASc: 4.7 ± 1.5)随机分成LAAC组(n=201)和DOAC组(n=201),LAAC的成功率为90%。在DOAC组中,apixaban是最常用的(95.5%),主要终点事件是中风、短暂性脑缺血发作、全身性栓塞、心血管死亡、主要或非主要临床相关出血或与手术/器械相关的并发症。经过平均19.9个月的随访,LAAC组和DOAC组的每年的主要终点事件发生率分别是10.99%和13.42%。两组间复合终点的组成没有差异。另外,有9名患者发生主要LAAC相关性并发症。

研究显示,在高卒中或出血风险的房颤患者中,LAAC在预防与房颤相关的心血管、神经和出血事件方面不优于DOAC。

原始出处:

Pavel O et al.Left Atrial Appendage Closure Versus Direct Oral Anticoagulants in High-Risk Patients With Atrial Fibrillation.JACC.2020 June.

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    2020-11-26 ycmayy
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    2021-03-05 hbwxf
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status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1031280, encodeId=1676103128048, content=房颤,临床上碰到很多哦, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=心介, createdTime=Wed Jun 24 17:21:08 CST 2020, time=2020-06-24, status=1, ipAttribution=)]
  5. 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status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1031280, encodeId=1676103128048, content=房颤,临床上碰到很多哦, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=心介, createdTime=Wed Jun 24 17:21:08 CST 2020, time=2020-06-24, status=1, ipAttribution=)]
  6. 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  7. 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status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1031280, encodeId=1676103128048, content=房颤,临床上碰到很多哦, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=心介, createdTime=Wed Jun 24 17:21:08 CST 2020, time=2020-06-24, status=1, ipAttribution=)]
  8. 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href='/topic/show?id=d15a4808371' target=_blank style='color:#2F92EE;'>#左心耳#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=48083, encryptionId=d15a4808371, topicName=左心耳)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=386b5684768, createdName=jxrzshh, createdTime=Fri Jun 26 05:21:08 CST 2020, time=2020-06-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1614552, encodeId=fc0e1614552a6, content=<a href='/topic/show?id=64f95426122' target=_blank style='color:#2F92EE;'>#房颤患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54261, encryptionId=64f95426122, topicName=房颤患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=937e19519012, createdName=hittouch, createdTime=Fri Jun 26 05:21:08 CST 2020, time=2020-06-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1031280, encodeId=1676103128048, content=房颤,临床上碰到很多哦, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=心介, createdTime=Wed Jun 24 17:21:08 CST 2020, time=2020-06-24, status=1, ipAttribution=)]
    2020-06-26 jxrzshh
  9. [GetPortalCommentsPageByObjectIdResponse(id=2061004, encodeId=c16e2061004fd, content=<a href='/topic/show?id=e70046e74d3' target=_blank style='color:#2F92EE;'>#封堵术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=46774, encryptionId=e70046e74d3, topicName=封堵术)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c805395, createdName=ycmayy, createdTime=Thu Nov 26 01:21:08 CST 2020, time=2020-11-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1862130, encodeId=ea18186213028, content=<a href='/topic/show?id=a374102813a1' target=_blank style='color:#2F92EE;'>#高风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=102813, encryptionId=a374102813a1, topicName=高风险)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f5e185, 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  10. 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status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1031280, encodeId=1676103128048, content=房颤,临床上碰到很多哦, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=心介, createdTime=Wed Jun 24 17:21:08 CST 2020, time=2020-06-24, status=1, ipAttribution=)]
    2020-06-24 心介

    房颤,临床上碰到很多哦

    0

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