停用抗凝时间对连续血流左心室辅助装置患者的影响。

IF 1.1 4区 医学 Q4 ENGINEERING, BIOMEDICAL
Journal of Artificial Organs Pub Date : 2023-12-01 Epub Date: 2022-10-08 DOI:10.1007/s10047-022-01367-8
Christian A Inchaustegui, Ashley Patel, Harveen K Lamba, Andrew Brown, Justin Arunthamakun, Kevin Ting, Subhasis Chatterjee, Ajith P Nair, Joggy K George, Alexis E Shafii, Kenneth K Liao, Andrew B Civitello
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引用次数: 0

摘要

使用左心室辅助装置(lvad)的患者接受抗凝治疗以降低血栓形成的风险。在各种情况下,LVAD患者需要停止抗凝治疗,但所涉及的风险尚未明确定义。在对LVAD植入过程的回顾性回顾中,我们检查了停药时间对植入后血栓形成和死亡率的影响。采用≤1.5的国际标准化比值筛选停用抗凝治疗的患者。按停药天数将患者分为三组:未停药组、短期停药组(
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Impact of time off anticoagulation in patients with continuous-flow left ventricular assist devices.

Impact of time off anticoagulation in patients with continuous-flow left ventricular assist devices.

Patients with left ventricular assist devices (LVADs) receive anticoagulation to decrease the risk of thrombosis. Various circumstances require discontinuing anticoagulation in LVAD patients, but the risks entailed are not well defined. In a retrospective review of LVAD implantation procedures, we examined the effect of time off anticoagulation on thrombosis and mortality rates after implantation. An international normalized ratio ≤ 1.5 was used to screen for patients taken off anticoagulation. Patients were divided into three groups by the cumulative number of days off anticoagulation: no discontinuation, short-term discontinuation (< 30 days), and long-term discontinuation (≥ 30 days). Rates of ischemic stroke, pump thrombosis, and mortality were compared among groups. Of 245 patients who underwent LVAD implantation during the study, 70 (28.6%) were off anticoagulation during follow-up: 37 (15.1%) had short-term discontinuation (median, 11 days), and 33 (13.5%) had long-term discontinuation (median, 124 days). Patients with long-term discontinuation had a higher rate of ischemic stroke (adjusted hazard ratio 8.5, p = 0.001) and death (adjusted hazard ratio 3.9, p = 0.001). The three groups did not differ in pump thrombosis rate. We conclude that after LVAD implantation, discontinuing anticoagulation for ≥ 30 days is independently associated with an increased risk of ischemic stroke and death.

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来源期刊
Journal of Artificial Organs
Journal of Artificial Organs 医学-工程:生物医学
CiteScore
2.80
自引率
15.40%
发文量
68
审稿时长
6-12 weeks
期刊介绍: The aim of the Journal of Artificial Organs is to introduce to colleagues worldwide a broad spectrum of important new achievements in the field of artificial organs, ranging from fundamental research to clinical applications. The scope of the Journal of Artificial Organs encompasses but is not restricted to blood purification, cardiovascular intervention, biomaterials, and artificial metabolic organs. Additionally, the journal will cover technical and industrial innovations. Membership in the Japanese Society for Artificial Organs is not a prerequisite for submission.
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