■为了描述特征,治疗实践,室壁血栓(VMT)患者的临床结局,重点比较非维生素K拮抗剂口服抗凝剂(NOAC)和维生素K拮抗剂(VKAs)。
■我们在2010年至2019年期间在阜外医院进行了一项回顾性队列研究,中国。包括新接受NOAC或VKAs治疗的VMT患者。主要结果是3个月时血栓消退的发生率。
■我们共纳入196例患者,68.9%(n=135)接受VKAs治疗,31.1%(n=61)接受NOAC治疗。有心力衰竭(HF)病史的患者(比值比(OR)2.10,95%置信区间(CI)1.17至3.77,p=0.013)和较低的左心室射血分数(OR0.36,95%CI0.20至0.65,p=0.001)具有较高的血栓分辨率。3个月时,在有或无校正的情况下,观察到NOAC组和VKAs组之间的血栓分辨率存在显著差异(OR2.61,95%CI1.39~4.89,p=0.003;校正OR2.93,95%CI1.51~5.66,p=0.001).进一步的调查显示,在大多数亚组中,接受NOAC治疗的患者的血栓消退率优于接受VKA治疗的患者.
■有HF病史或左心室射血分数<30%的患者在血栓消退方面具有更大的有效性。此外,在3个月时,NOAC治疗的VMT分辨率明显高于VKA治疗,有或没有调整基线变量。
■这项研究于8月4日在ClinicalTrials.gov注册为NCT05006677,2021年。
UNASSIGNED: To describe the characteristics, treatment practices, and clinical outcomes of patients with ventricular mural thrombus (VMT), with emphasis on the comparison of non-vitamin K antagonist oral anticoagulants (NOACs) and vitamin K antagonists (VKAs).
UNASSIGNED: We performed a retrospective cohort study between 2010 and 2019 in Fuwai Hospital, China. Patients with VMT newly treated with either NOACs or VKAs were included. The primary outcome was the incidence rate of thrombus resolution at 3 months.
UNASSIGNED: We included 196 patients in total-68.9% (n = 135) were treated with VKAs while 31.1% (n = 61) were on NOACs. Patients with a medical history of heart failure (HF) (odds ratio (OR) 2.10, 95% confidence interval (CI) 1.17 to 3.77, p = 0.013) and a lower left ventricular ejection fraction (OR 0.36, 95% CI 0.20 to 0.65, p = 0.001) had a higher thrombus resolution. At 3 months, a significant difference was observed in the thrombus resolution between the NOACs and VKAs group with or without adjustment (OR 2.61, 95% CI 1.39 to 4.89, p = 0.003; adjusted OR 2.93, 95% CI 1.51 to 5.66, p = 0.001). Further investigation revealed that in the majority of the subgroups, individuals receiving NOAC therapy had a superior thrombus resolution than those receiving VKA therapy.
UNASSIGNED: Patients with a medical history of HF or left ventricular ejection fraction < 30% experienced greater effectiveness in thrombus resolution. Additionally, the resolution of VMT with NOAC treatment was considerably higher than that with VKA therapy at 3 months, with or without adjusting for baseline variables.
UNASSIGNED: This study was registered at ClinicalTrials.gov as NCT05006677 on August 4th, 2021.