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Europace:中国房颤注册研究全新分析:房颤消融成功3个月后或可安全停用口服抗凝药

2019-09-24 中国循环杂志 朱柳媛

近期,首都医科大学附属北京安贞医院马长生教授领衔的中国房颤注册登记研究组在Europace杂志上发表的一项最新研究结果表明,房颤患者如果既往没有缺血性中风、短暂性脑缺血发作、系统性血栓栓塞等病史,也不合并糖尿病,那么成功进行导管消融术后3个月时,可安全停用口服抗凝药物。

 近期,首都医科大学附属北京安贞医院马长生教授领衔的中国房颤注册登记研究组在Europace杂志上发表的一项最新研究结果表明,房颤患者如果既往没有缺血性中风、短暂性脑缺血发作、系统性血栓栓塞等病史,也不合并糖尿病,那么成功进行导管消融术后3个月时,可安全停用口服抗凝药物。
 
实际上,在2018年3月召开的美国心脏病学会(ACC)年会上,该研究团队就已经报告了该研究的更早期研究结果。两次研究得出的结果一致。
 
研究者表示,该研究结果还需要大规模的随机临床试验来进一步证实。
 
我国于2018年发布的一项房颤共识建议,房颤患者射频消融术后至少需要应用华法林或新型口服抗凝药治疗2个月,2个月后是否继续抗凝取决于患者的脑卒中风险。
 
研究者发现,在大约两年的随访期间,消融术后3个月时停用口服抗凝药物的患者中,血栓栓塞事件(0.54/百人年 vs 0.86/百人年)和大出血事件(0.19/百人年 vs 0.35/百人年)的发生率均明显低于继续应用口服抗凝药物的患者。
 
多变量分析显示,既往有缺血性中风/短暂性脑缺血发作/系统性血栓栓塞等病史(HR=3.4)以及糖尿病(HR=2.06)是消融术后房颤患者发生血栓栓塞事件的独立危险因素,而停用口服抗凝药物与血栓栓塞事件无关(HR=0.71, 95% CI:0.41~1.23,P=0.21)。
 
该研究是一项前瞻性、多中心的注册登记研究,连续纳入4512例成功接受房颤消融术的患者,其中3149例在术后3个月时停用口服抗凝药物,其余1363例继续应用抗凝药物。两组患者的平均随访期分别为24.2个月和23个月。
 
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    2020-05-01 shanyongle
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    2019-09-26 zhyy93

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