JACC:房颤患者接受左心耳封堵术或新型口服抗凝剂治疗的4年预后比较

2022-01-17 “心关注”公众号 “心关注”公众号

近日,发表在JACC杂志上的PRAGUE-17研究结果表明,左心耳封堵术(LAAC)在预防房颤(AF)高危人群的主要心血管、神经或出血事件方面不劣于直接口服抗凝剂(DOACs)。

近日,发表在JACC杂志上的PRAGUE-17研究结果表明,左心耳封堵术(LAAC)在预防房颤(AF)高危人群的主要心血管、神经或出血事件方面不劣于直接口服抗凝剂(DOACs);此外,LAAC显着减少非手术性临床相关出血

PRAGUE-17研究是一项随机非劣效性试验,比较经皮LAAC(Watchman或Amulet封堵器)与DOACs在治疗非瓣膜性AF、有心脏栓塞病史、临床相关出血或CHA2DS2-VASc ≥3和HAS-BLED≥2患者中的应用。主要终点是心源性栓塞事件(卒中、短暂性脑缺血发作或全身栓塞)、心血管死亡、临床相关出血或手术/设备相关并发症的复合终点。

研究共随机抽取402例AF患者(每组201例,年龄73.3±7.0岁,65.7%为男性,CHA2DS2-VASc 4.7±1.5,HAS-BLED 3.1±0.9)。在3.5年的中位随访后, LAAC在主要终点方面不劣于DOACs(sHR 0.81,95%CI 0.56-1.18;P=0.27,非劣效性P=0.006)。对于复合终点的组成部分,心血管死亡的sHR为0.68(95%CI 0.39-1.20;P=0.19)、卒中/短暂性脑缺血发作的sHR为1.14(95%CI 0.56-2.30;P=0.72)、临床相关出血的sHR为0.75(95%CI 0.44-1.27;P=0.28),非手术性临床相关出血的sHR为0.55(95%CI 0.31-0.97;P=0.039)。主要终点在符合方案集分析(sHR 0.80,95%CI 0.54-1.18;P=0.25)和接受治疗分析(sHR 0.82,95%CI 0.56-1.20;P=0.30)中结果相似。

 

原始出处:

Pavel Osmancik, Dalibor Herman, Petr Neuzil, et al. 4-Year Outcomes After Left Atrial Appendage Closure Versus Nonwarfarin Oral Anticoagulation for Atrial Fibrillation. J Am Coll Cardiol. 2022 Jan, 79 (1) 1–14.

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    2022-12-25 ycmayy
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    2022-02-20 hbwxf
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    2022-01-18 ms6000000656440728

    证实左心耳封堵术很有优势

    0

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    2022-01-17 ms4000001513304915

    学习#学习#

    0

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    2022-01-12 jxrzshh
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