机械心脏瓣膜患者的人工瓣膜功能障碍：萨拉姆急救中心队列的结果。

IF 3.7 3区医学 Q1 HEMATOLOGY

Thrombosis research Pub Date : 2024-10-16 DOI:10.1016/j.thromres.2024.109183

Nicoletta Erba , Alberto Tosetto , Suha Abdelwahab Abdallah , Martin Langer , Elena Giovanella , Salvatore Lentini , Franco Masini , Alessandro Mocini , Gennarina Portella , Alessandro Cristian Salvati , Alessandro Squizzato , Sophie Testa , Daniela Poli

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引用次数: 0

摘要

导言：由于人工瓣膜功能障碍（PVD）和心肌栓塞的风险，机械心脏瓣膜（MHV）置换术需要长期抗凝治疗：我们报告了由意大利非政府组织 "Emergency "建立的喀土穆萨拉姆心脏外科中心对人工心脏瓣膜置换术患者进行的前瞻性观察研究的数据，以评估PVD的发生率和相关风险因素：我们对 3647 名患者进行了前瞻性随访，38 名患者（比率为 1.04 × 100 pt-年）在随访期间出现了心血管病变。无 PVD 患者的治疗范围时间（TTR）为 53%（IQR 37-67），PVD 患者的治疗范围时间（TTR）为 43%（IQR 19-58）（P = 0.04）。38 名患者中有 23 人（60.5%）有症状，18 人（47.4%）有阻塞性瓣膜狭窄，24 人（63.2%）INR 为 4 周（6 人停用华法林 3 至 12 个月）。10 名患者未遵从治疗方案，8 名患者为孕妇。10 名心血管疾病患者（26.3%）曾有过心血管疾病发作，14 名患者（36.8%）有 2 个或更多相关风险因素。只有6例患者没有发现相关风险因素：结论：在接受华法林治疗且抗凝质量不达标的 MHV 患者中，PVD 的发生率为 1.04 % pt-年，发生 PVD 的最常见相关风险因素是持续一周以上的华法林停药。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

Prosthetic valve dysfunction in patients with mechanical heart valves: Results from the Emergency Salam Centre cohort

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Prosthetic valve dysfunction in patients with mechanical heart valves: Results from the Emergency Salam Centre cohort

Introduction

Mechanical heart valve (MHV) replacement requires long-life anticoagulation due to the risk of Prosthetic Valve Dysfunction (PVD) and cardioembolism.

Methods

We report data from a prospective observational study conducted on MHV patients in the Khartoum Salam Centre for Cardiac Surgery built by ‘Emergency,’ an Italian Non-Governmental Organization, to evaluate the occurrence of PVD and associated risk factors.

Results

We prospectively followed 3647 patients, and 38 patients (rate 1.04 × 100 pt-years) had PVD during follow-up. The time in therapeutic range (TTR) among patients without PVD was 53 % (IQR 37–67), and it was 43 % (IQR 19–58) among patients with PVD (p = 0.04). Twenty-three over 38 patients (60.5 %) were symptomatic, 18 (47.4 %) had obstructive valvular stenosis, 24 patients (63.2 %) had INR <2.0 at diagnosis, and 21 patients (55.3 %) had been off warfarin for a long time: 3 patients for 1 week, 1 patient for 2 weeks, and 17 patients for >4 weeks (6 patients were off warfarin from 3 to 12 months). Ten were uncompliant to treatment, and 8 were pregnant women. Ten patients (26.3 %) with PVD had had a previous episode of PVD, and 14 patients (36.8 %) had 2 or more associated risk factors. Only in 6 cases were no associate risk factors found.

Conclusions

Among MHV patients on warfarin treatment with a sub-optimal quality of anticoagulation, the rate of PVD is 1.04 % pt-years, and the most frequent associated risk factor for PVD occurrence is warfarin withdrawal lasting more than one week.

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来源期刊

Thrombosis research 医学-外周血管病

CiteScore

14.60

自引率

4.00%

发文量

364

审稿时长

31 days

期刊介绍： Thrombosis Research is an international journal dedicated to the swift dissemination of new information on thrombosis, hemostasis, and vascular biology, aimed at advancing both science and clinical care. The journal publishes peer-reviewed original research, reviews, editorials, opinions, and critiques, covering both basic and clinical studies. Priority is given to research that promises novel approaches in the diagnosis, therapy, prognosis, and prevention of thrombotic and hemorrhagic diseases.