[1].LAmbreTM封堵器与新型口服抗凝药物预防心房颤动患者血栓栓塞事件的对照研究[J].心血管病学进展,2021,(11):1036-1039.[doi:10.16806/j.cnki.issn.1004-3934.2021.11.000]
　LI YahuiWANG XuewenHUANG Congxin.A Comparative Study of LAmbreTM Device and Direct Oral Anticoagulants in Preventing Thromboembolic Events in Patients with Atrial Fibrillation[J].Advances in Cardiovascular Diseases,2021,(11):1036-1039.[doi:10.16806/j.cnki.issn.1004-3934.2021.11.000]
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LAmbreTM封堵器与新型口服抗凝药物预防心房颤动患者血栓栓塞事件的对照研究()
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《心血管病学进展》[ISSN:51-1187/R/CN:1004-3934]

卷:
期数:
2021年11期
页码:
1036-1039
栏目:
论著
出版日期:
2021-11-25

文章信息/Info

Title:
A Comparative Study of LAmbreTM Device and Direct Oral Anticoagulants in Preventing Thromboembolic Events in Patients with Atrial Fibrillation
文章编号:
202105093
作者:
(1．武汉大学人民医院心血管内科,湖北 武汉 430060;2．武汉大学心血管病研究所 心血管病湖北省重点实验室,湖北 武汉 430060)
Author(s):
LI Yahui1WANG Xuewen1HUANG Congxin1; 2
Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan 430060HubeiChina2. Cardiovascular Research Institute, Wuhan University, Wuhan 430060 HubeiChinaHubei Key Laboratory of Cardiology, Wuhan 430060, HubeiChina)
关键词:
心房颤动; 左心耳封堵; 新型口服抗凝药物; 血栓栓塞
Keywords:
Atrial fibrillation; Left atrial appendage closure; Direct oral anticoagulants; Thromboembolism
DOI:
10.16806/j.cnki.issn.1004-3934.2021.11.000
摘要:
目的 研究中国心房颤动（房颤）患者行左心耳封堵（LAAC）与直接口服抗凝药物预防血栓栓塞事件的安全性和有效性。方法 入选2018年7月—2020年12月于武汉大学人民医院心律失常专科接受LAAC的非瓣膜性房颤患者48 例（LAAC组）。术后使用双联抗血小板聚集治疗（阿司匹林+氯吡格雷）至少3个月，在第3个月时根据经食管超声心动图检查结果，将双抗血小板改为单抗血小板药物治疗。同期选择48例使用新型口服抗凝药物（DOACs）预防血栓栓塞事件的非瓣膜性房颤患者作为对照组（DOACs组）。均于患者出院后1、3、6个月进行随访，观察两组在随访期间预防血栓栓塞事件的安全性和有效性。结果 安全性比较：LAAC组手术成功率为100％，围手术期有1例发生心脏压塞事件，无脑卒中、死亡和器械栓塞等并发症。随访半年内两组均无器械相关栓塞或死亡等不良事件发生。LAAC组随访半年内有5例出血事件，DOACs组有11例（P＞0.05）。但LAAC组在随访3个月后无出血事件，而DOACs组有5例出血事件（P＜0.05）。有效性比较：随访半年内LAAC组与DOACs组均无血栓栓塞事件发生。结论 使用国产 LAmbreTM封堵器预防房颤患者血栓栓塞安全及有效，可减少3个月后消化道出血事件。
Abstract:
Objective To investigate the safety and efficacy of left atrial appendage closure（LAAC) and direct oral anticoagulants in the prevention of thromboembolic events in Chinese patients with atrial fibrillation （AF）. Methods We selected 48 nonvalvular AF who received LAAC in the Arrhythmia Department of Renmin Hospital of Wuhan University from July 2018 to December 2020（LAAC group). Dual antiplatelet aggregation therapy (aspirin plus clopidogrel) was used for at least 3 months postoperatively. In the third month,the dual antiplatelet therapy was changed to single antiplatelet therapy based on transesophageal echocardiography(TEE) findings. During the same period,48 patients with NVAF who received direct oral anticoagulants to prevent thromboembolic events were selected as the control group （DOACs group). After discharge,patients were followed at 1, 3 and 6 months, the safety and effectiveness were evaluated. Results Security comparison:the success rate was 100% in the LAAC group. There was 1 case of cardiac tamponade during the perioperative period,and no complications such as cerebral stroke, death and thrombosis on the occluder surface was observed. During the follow-up period of half a year,no device related embolism,death or other adverse events occurred in both groups. During the six-month follow-up,there were 5 bleeding events in the LAAC group and 11 in the DOACS group(P＞0.05). After 3 months, there were no bleeding events in the LAAC group,while 5 bleeding events in the DOACS group(P＜0.05). Validity comparison:follow-up for half a year,there was no thromboembolic event in the LAAC group and the DOACs group. Conclusion The LAmbreTM occluder is safe and effective in preventing thromboembolism in patients with atrial fibrillation and can reduce the incidence of gastrointestinal bleeding after 3 months.

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更新日期/Last Update: 2021-12-06