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JACC:经导管主动脉瓣置换术后早期小叶血栓的中期随访

2018-06-20 xiangting MedSci原创

这一经导管主动脉瓣置换术后接受CT血管造影的前瞻性观察队列中,随访406天期间,LT与死亡率或卒中发病率升高无关。

这项研究目的是调查小叶血栓形成(LT)患者的中期预后。经导管主动脉瓣置换术后,大约10%的患者通过CT血管造影诊断为早期LT,早期LT的临床意义尚不明确。

在这项观察性研究中,患者经导管主动脉瓣置换术后中位5天进行CT造影,评估LT的证据。随访包括临床访视、电话联系或问卷调查。

754例患者中120例(15.9%)被诊断LT。LT患者中男性的比率较低(36.7%vs.47.0%,p=0.045),房颤发生率较低(28.3%vs.41.5%,p=0.008)。组间的术前和术后特征相当(例如瓣膜植入技术;p=0.116)。在中位随访的406天期间,LT患者和无LT患者的全因死亡率主要终点和卒中、短暂性脑缺血发作的次要复合终点无显著差异(18个月Kaplan-Meier估算死亡率为86.6%vs.85.4%,p=0.912;无卒中或短暂性缺血发作生存率为98.5%vs.96.8%,p=0.331)。在单因素和多因素分析中,LT无法预测任一终点,而男性(p=0.03)、房颤(p=0.002)和轻度以上瓣周漏(p=0.015)与全因死亡率相关。

这一经导管主动脉瓣置换术后接受CT血管造影的前瞻性观察队列中,随访406天期间,LT与死亡率或卒中发病率升高无关。

原始出处:
Philipp Ruile, et al. Medium-Term Follow-Up of Early Leaflet Thrombosis After Transcatheter Aortic Valve Replacement. JACC:Cardiovascular Interventions. 25 June 2018.

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    2019-03-04 hbwxf
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    2018-06-24 yxch48
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  5. [GetPortalCommentsPageByObjectIdResponse(id=1967390, encodeId=579e196e390ca, content=<a href='/topic/show?id=e6ac46988a5' target=_blank style='color:#2F92EE;'>#小叶血栓#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=46988, encryptionId=e6ac46988a5, topicName=小叶血栓)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=052a130, createdName=yyj062, createdTime=Fri Aug 31 13:32:00 CST 2018, time=2018-08-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1854066, encodeId=82631854066fd, content=<a href='/topic/show?id=48351020537' target=_blank style='color:#2F92EE;'>#JACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10205, encryptionId=48351020537, topicName=JACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=55ce62, 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  6. 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  7. 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Jun 22 06:32:00 CST 2018, time=2018-06-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1576628, encodeId=a86715e6628dd, content=<a href='/topic/show?id=48fee966468' target=_blank style='color:#2F92EE;'>#置换术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79664, encryptionId=48fee966468, topicName=置换术)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=054816326830, createdName=ms117281293605716, createdTime=Fri Jun 22 06:32:00 CST 2018, time=2018-06-22, status=1, ipAttribution=)]
  8. [GetPortalCommentsPageByObjectIdResponse(id=1967390, encodeId=579e196e390ca, content=<a href='/topic/show?id=e6ac46988a5' target=_blank style='color:#2F92EE;'>#小叶血栓#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=46988, encryptionId=e6ac46988a5, topicName=小叶血栓)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=052a130, createdName=yyj062, createdTime=Fri Aug 31 13:32:00 CST 2018, time=2018-08-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1854066, encodeId=82631854066fd, content=<a href='/topic/show?id=48351020537' target=_blank style='color:#2F92EE;'>#JACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10205, encryptionId=48351020537, topicName=JACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=55ce62, createdName=hbwxf, createdTime=Mon Mar 04 07:32:00 CST 2019, time=2019-03-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1742505, encodeId=c05b1e42505f3, content=<a href='/topic/show?id=39cae96626f' target=_blank style='color:#2F92EE;'>#置换#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79662, encryptionId=39cae96626f, topicName=置换)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=3a7c35056336, createdName=yxch48, createdTime=Sun Jun 24 14:32:00 CST 2018, time=2018-06-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1325868, encodeId=b189132586847, content=<a href='/topic/show?id=96c71804b7' target=_blank style='color:#2F92EE;'>#ACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1804, encryptionId=96c71804b7, topicName=ACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1e452500029, createdName=12498568m50暂无昵称, createdTime=Fri Jun 22 06:32:00 CST 2018, time=2018-06-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1332530, encodeId=b7461332530e0, content=<a href='/topic/show?id=1dd6231822d' target=_blank style='color:#2F92EE;'>#主动脉瓣#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23182, encryptionId=1dd6231822d, topicName=主动脉瓣)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=dc4b2500077, createdName=hittouch, createdTime=Fri Jun 22 06:32:00 CST 2018, time=2018-06-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1367124, encodeId=13c1136e12450, content=<a href='/topic/show?id=b6222320322' target=_blank style='color:#2F92EE;'>#主动脉瓣置换术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23203, encryptionId=b6222320322, topicName=主动脉瓣置换术)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0b24249, createdName=medsci246, createdTime=Fri Jun 22 06:32:00 CST 2018, time=2018-06-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1415326, encodeId=dec31415326ec, content=<a href='/topic/show?id=04812314540' target=_blank style='color:#2F92EE;'>#主动脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23145, encryptionId=04812314540, topicName=主动脉)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=77603112682, createdName=circumcision, createdTime=Fri Jun 22 06:32:00 CST 2018, time=2018-06-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1510144, encodeId=e95b151014460, content=<a href='/topic/show?id=e9bce8254ef' target=_blank style='color:#2F92EE;'>#经导管#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78254, encryptionId=e9bce8254ef, topicName=经导管)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=93e010191378, createdName=lsj631, createdTime=Fri Jun 22 06:32:00 CST 2018, time=2018-06-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1536535, encodeId=ee691536535c3, content=<a href='/topic/show?id=a894e826546' target=_blank style='color:#2F92EE;'>#经导管主动脉瓣置换#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78265, encryptionId=a894e826546, topicName=经导管主动脉瓣置换)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b38112697961, createdName=yytms, createdTime=Fri Jun 22 06:32:00 CST 2018, time=2018-06-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1576628, encodeId=a86715e6628dd, content=<a href='/topic/show?id=48fee966468' target=_blank style='color:#2F92EE;'>#置换术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79664, encryptionId=48fee966468, topicName=置换术)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=054816326830, createdName=ms117281293605716, createdTime=Fri Jun 22 06:32:00 CST 2018, time=2018-06-22, status=1, ipAttribution=)]
    2018-06-22 lsj631
  9. [GetPortalCommentsPageByObjectIdResponse(id=1967390, encodeId=579e196e390ca, content=<a href='/topic/show?id=e6ac46988a5' target=_blank style='color:#2F92EE;'>#小叶血栓#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=46988, encryptionId=e6ac46988a5, topicName=小叶血栓)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=052a130, createdName=yyj062, createdTime=Fri Aug 31 13:32:00 CST 2018, time=2018-08-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1854066, encodeId=82631854066fd, content=<a href='/topic/show?id=48351020537' target=_blank style='color:#2F92EE;'>#JACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10205, encryptionId=48351020537, topicName=JACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=55ce62, 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encryptionId=96c71804b7, topicName=ACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1e452500029, createdName=12498568m50暂无昵称, createdTime=Fri Jun 22 06:32:00 CST 2018, time=2018-06-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1332530, encodeId=b7461332530e0, content=<a href='/topic/show?id=1dd6231822d' target=_blank style='color:#2F92EE;'>#主动脉瓣#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23182, encryptionId=1dd6231822d, topicName=主动脉瓣)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=dc4b2500077, createdName=hittouch, createdTime=Fri Jun 22 06:32:00 CST 2018, time=2018-06-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1367124, encodeId=13c1136e12450, content=<a href='/topic/show?id=b6222320322' target=_blank style='color:#2F92EE;'>#主动脉瓣置换术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23203, encryptionId=b6222320322, topicName=主动脉瓣置换术)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0b24249, createdName=medsci246, createdTime=Fri Jun 22 06:32:00 CST 2018, time=2018-06-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1415326, encodeId=dec31415326ec, content=<a href='/topic/show?id=04812314540' target=_blank style='color:#2F92EE;'>#主动脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23145, encryptionId=04812314540, topicName=主动脉)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=77603112682, createdName=circumcision, createdTime=Fri Jun 22 06:32:00 CST 2018, time=2018-06-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1510144, encodeId=e95b151014460, content=<a href='/topic/show?id=e9bce8254ef' target=_blank style='color:#2F92EE;'>#经导管#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78254, encryptionId=e9bce8254ef, topicName=经导管)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=93e010191378, createdName=lsj631, createdTime=Fri Jun 22 06:32:00 CST 2018, time=2018-06-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1536535, encodeId=ee691536535c3, content=<a href='/topic/show?id=a894e826546' target=_blank style='color:#2F92EE;'>#经导管主动脉瓣置换#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78265, encryptionId=a894e826546, topicName=经导管主动脉瓣置换)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b38112697961, createdName=yytms, createdTime=Fri 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  10. [GetPortalCommentsPageByObjectIdResponse(id=1967390, encodeId=579e196e390ca, content=<a href='/topic/show?id=e6ac46988a5' target=_blank style='color:#2F92EE;'>#小叶血栓#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=46988, encryptionId=e6ac46988a5, topicName=小叶血栓)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=052a130, createdName=yyj062, createdTime=Fri Aug 31 13:32:00 CST 2018, time=2018-08-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1854066, encodeId=82631854066fd, content=<a href='/topic/show?id=48351020537' target=_blank style='color:#2F92EE;'>#JACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10205, encryptionId=48351020537, topicName=JACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=55ce62, 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Jun 22 06:32:00 CST 2018, time=2018-06-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1576628, encodeId=a86715e6628dd, content=<a href='/topic/show?id=48fee966468' target=_blank style='color:#2F92EE;'>#置换术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79664, encryptionId=48fee966468, topicName=置换术)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=054816326830, createdName=ms117281293605716, createdTime=Fri Jun 22 06:32:00 CST 2018, time=2018-06-22, status=1, ipAttribution=)]
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