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Thromb Haemost:房颤患者左心房血栓发生的meta分析

2015-11-28 phylis 译 MedSci原创

研究者对房颤(AF)患者左心房血栓(LAT)发生的发生进行了meta分析,对AF患者行经食管超声心动图(TEE)检查是否存心左心房血栓。系统性搜索了PubMed,Web of Science,Scopus及EMBASE数据库进行研究AF患者LAT的发生,总LAT的发生应用加权平均患病率来评估(WMP)。72个研究(20516名AF患者)LAT的WMP为9.8 %(95 % CI:7.6 % - 1

研究者对房颤(AF)患者左心房血栓(LAT)的发生进行了meta分析,对AF患者行经食管超声心动图(TEE)检查是否存在左心房血栓。

系统性搜索了PubMed、Web of Science、Scopus及EMBASE数据库进行研究AF患者LAT的发生,总LAT的发生应用加权平均患病率来评估(WMP)。

72个研究(20516名AF患者)LAT的WMP为9.8 %(95 % CI:7.6 % - 12.5 %)。LAT的发生与高龄(均差:2.56,95 %CI:1.49-3.62)、女性患者(OR:1.35,95 % CI:1.04-1.75)、高血压(1.78,95%CI: 1.38-2.30)、糖尿病(1.86,95 %CI:1.33-2.59)及慢性心衰(3.67,95%CI: 2.40-5.60)相关。


总之,与未发生LAT的患者相比,LAT患者CHADS2分数较高(均差:0.88,95%CI: 0.68-1.07),卒中/全身性栓塞发生较高(OR: 3.53,95%CI: 2.24-5.56)。meta回归分析显示,LAT的发生与患者口服抗凝药存在负相关(Z值:-7.3)。全部应用口服抗凝药的患者,LAT的WMP为3.4 %(95 % CI:1.3 % - 8.7 %),而未接受抗凝药治疗的患者LAT的WMP为7.4 %(95 % CI:2.3 % 21.5 %)。研究数据显示:LAT存在于约10%的AF患者,与卒中/全身性栓塞的发生增加3.5倍相关。有趣的是,LAT也与应用抗凝药治疗相关。

对房颤患者进行电复律/消融治疗前应进行LAT的检查,这对于预防心血管事件的发生是有利的。

原文出处:

Di Minno MN, Ambrosino P, Dello Russo A,et al. Prevalence of left atrial thrombus in patients with non-valvular atrial fibrillation. A systematic review and meta-analysis of the literature.Thromb Haemost. 2015,Nov 26.

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    2016-11-01 一闲
  2. [GetPortalCommentsPageByObjectIdResponse(id=1895854, encodeId=a315189585482, content=<a href='/topic/show?id=4a391158248' target=_blank style='color:#2F92EE;'>#MET#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11582, encryptionId=4a391158248, topicName=MET)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=18fc139, createdName=一闲, createdTime=Tue Nov 01 18:51:00 CST 2016, time=2016-11-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2008215, encodeId=51ca20082158f, content=<a href='/topic/show?id=1066844469' target=_blank style='color:#2F92EE;'>#HAE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8444, encryptionId=1066844469, topicName=HAE)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=32d177, createdName=changfy, createdTime=Sat Jun 04 13:51:00 CST 2016, time=2016-06-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1659693, encodeId=40de165969354, content=<a href='/topic/show?id=da5c480e024' target=_blank style='color:#2F92EE;'>#左心房#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=48070, encryptionId=da5c480e024, topicName=左心房)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=50dc25016902, createdName=ylz8411, createdTime=Sat Jul 23 14:51:00 CST 2016, time=2016-07-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1887480, encodeId=8bad188e480a6, content=<a href='/topic/show?id=d56611584ec' target=_blank style='color:#2F92EE;'>#Meta#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11584, encryptionId=d56611584ec, topicName=Meta)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d8f4110, createdName=guojianrong, createdTime=Thu Aug 18 00:51:00 CST 2016, time=2016-08-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1614281, encodeId=9ceb1614281ac, 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=47, 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=Mon Nov 30 05:51:00 CST 2015, time=2015-11-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1626811, encodeId=9166162681103, content=<a href='/topic/show?id=986a5101e46' target=_blank style='color:#2F92EE;'>#心房#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=51017, encryptionId=986a5101e46, topicName=心房)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=20ba21064884, createdName=sodoo, createdTime=Mon Nov 30 05:51:00 CST 2015, time=2015-11-30, status=1, ipAttribution=)]
    2016-06-04 changfy
  3. [GetPortalCommentsPageByObjectIdResponse(id=1895854, encodeId=a315189585482, content=<a href='/topic/show?id=4a391158248' target=_blank style='color:#2F92EE;'>#MET#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11582, encryptionId=4a391158248, topicName=MET)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=18fc139, createdName=一闲, createdTime=Tue Nov 01 18:51:00 CST 2016, time=2016-11-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2008215, encodeId=51ca20082158f, content=<a href='/topic/show?id=1066844469' target=_blank style='color:#2F92EE;'>#HAE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8444, encryptionId=1066844469, topicName=HAE)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=32d177, createdName=changfy, createdTime=Sat Jun 04 13:51:00 CST 2016, time=2016-06-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1659693, encodeId=40de165969354, content=<a href='/topic/show?id=da5c480e024' target=_blank style='color:#2F92EE;'>#左心房#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=48070, encryptionId=da5c480e024, topicName=左心房)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=50dc25016902, createdName=ylz8411, createdTime=Sat Jul 23 14:51:00 CST 2016, time=2016-07-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1887480, encodeId=8bad188e480a6, content=<a href='/topic/show?id=d56611584ec' target=_blank style='color:#2F92EE;'>#Meta#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11584, encryptionId=d56611584ec, topicName=Meta)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d8f4110, createdName=guojianrong, createdTime=Thu Aug 18 00:51:00 CST 2016, time=2016-08-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1614281, encodeId=9ceb1614281ac, 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=47, 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=Mon Nov 30 05:51:00 CST 2015, time=2015-11-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1626811, encodeId=9166162681103, content=<a href='/topic/show?id=986a5101e46' target=_blank style='color:#2F92EE;'>#心房#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=51017, encryptionId=986a5101e46, topicName=心房)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=20ba21064884, createdName=sodoo, createdTime=Mon Nov 30 05:51:00 CST 2015, time=2015-11-30, status=1, ipAttribution=)]
    2016-07-23 ylz8411
  4. [GetPortalCommentsPageByObjectIdResponse(id=1895854, encodeId=a315189585482, content=<a href='/topic/show?id=4a391158248' target=_blank style='color:#2F92EE;'>#MET#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11582, encryptionId=4a391158248, topicName=MET)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=18fc139, createdName=一闲, createdTime=Tue Nov 01 18:51:00 CST 2016, time=2016-11-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2008215, encodeId=51ca20082158f, content=<a href='/topic/show?id=1066844469' target=_blank style='color:#2F92EE;'>#HAE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8444, encryptionId=1066844469, topicName=HAE)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=32d177, createdName=changfy, createdTime=Sat Jun 04 13:51:00 CST 2016, time=2016-06-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1659693, encodeId=40de165969354, content=<a href='/topic/show?id=da5c480e024' target=_blank style='color:#2F92EE;'>#左心房#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=48070, encryptionId=da5c480e024, topicName=左心房)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=50dc25016902, createdName=ylz8411, createdTime=Sat Jul 23 14:51:00 CST 2016, time=2016-07-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1887480, encodeId=8bad188e480a6, content=<a href='/topic/show?id=d56611584ec' target=_blank style='color:#2F92EE;'>#Meta#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11584, encryptionId=d56611584ec, topicName=Meta)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d8f4110, createdName=guojianrong, createdTime=Thu Aug 18 00:51:00 CST 2016, time=2016-08-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1614281, encodeId=9ceb1614281ac, 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=47, 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=Mon Nov 30 05:51:00 CST 2015, time=2015-11-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1626811, encodeId=9166162681103, content=<a href='/topic/show?id=986a5101e46' target=_blank style='color:#2F92EE;'>#心房#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=51017, encryptionId=986a5101e46, topicName=心房)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=20ba21064884, createdName=sodoo, createdTime=Mon Nov 30 05:51:00 CST 2015, time=2015-11-30, status=1, ipAttribution=)]
    2016-08-18 guojianrong
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    2015-11-30 sodoo

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