利伐沙班对肥厚型心肌病合并心房颤动抗凝疗效评估
黄尚玮 （ 同济大学附属东方医院 ）
张 奇 （ 同济大学附属东方医院心内科 ）
李纪明 （ 同济大学附属东方医院 ）
https://doi.org/10.37155/2717-5693-0102-1Abstract
目的：房颤是肥厚型心肌病患者最常见的心律失常，且明显增加卒中及死亡风险。本研究就利伐沙班在肥厚型心肌病合并房颤的患者中的抗凝疗效进行评估。方法：将本中心2018年1月至2019年6月住院的肥厚型心肌病合并房颤患者作为研究对象，随访至今，收集患者临床资料，及记录随访结果。结果：共纳入7例患者，平均年龄为74.4±4.6岁。患者中除1例患者口服10 mg利伐沙班外，余6例均为15 mg。平均随访时间为18.3±3.9月，未出现缺血性卒中、全身性栓塞事件及大出血事件。结论：在本研究中，肥厚型心肌病合并房颤的患者使用利伐沙班抗凝未见明显栓塞事件，亦无出血事件。
Keywords
肥厚性心肌病; 心房颤动; 抗凝; 利伐沙班Full Text
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[6] Siontis KC, Geske JB, Ong K, Nishimura RA, Ommen SR, Gersh BJ. Atrial fibrillation in hypertrophic cardiomyopathy: prevalence, clinical correlations, and mortality in a large high-risk population[J]. J Am Heart Assoc. 2014;3: e001002. doi:10.1161/JAHA.114.001002
[7] Lee SE, Park JK, Uhm JS, Kim JY, Pak HN, Lee MH, et al. Impact of atrial fibrillation on the clinical course of apical hypertrophic cardiomyopathy[J]. Heart. 2017;103: 1496–1501. doi:10.1136/heartjnl-2016-310720
[8] Lip GYH, Nieuwlaat R, Pisters R, Lane DA, Crijns HJGM, Andresen D, et al. Refining clinical risk stratification for predicting stroke and thromboembolism in atrial fibrillation using a novel risk factor-based approach: The Euro Heart Survey on atrial fibrillation[J]. Chest. 2010;137: 263–272. doi:10.1378/chest.09-1584
[9] Guttmann OP, Rahman MS, O’Mahony C, Anastasakis A, Elliott PM. Atrial fibrillation and thromboembolism in patients with hypertrophic cardiomyopathy: systematic review[J]. Heart. 2014;100: 465–72. doi:10.1136/heartjnl-2013-304276
[10] Jung H, Yang P-S, Sung J-H, Jang E, Yu HT, Kim T-H, et al. Hypertrophic Cardiomyopathy in Patients with Atrial Fibrillation: Prevalence and Associated Stroke Risks in a Nationwide Cohort Study[J]. Thromb Haemost. 2019;119: 285–293. doi:10.1055/s-0038-1676818
[11] American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines, American Association for Thoracic Surgery, American Society of Echocardiography, American Society of Nuclear Cardiology, Heart Failure Society of America, Heart Rhythm Society, et al. 2011 ACCF/AHA guideline for the diagnosis and treatment of hypertrophic cardiomyopathy: executive summary: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines[J]. J Thorac Cardiovasc Surg. 2011;142: 1303–38. doi:10.1016/j.jtcvs.2011.10.019
[12] January CT, Wann LS, Calkins H, Chen LY, Cigarroa JE, Cleveland JC, et al. 2019 AHA/ACC/HRS Focused Update of the 2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society[J]. J Am Coll Cardiol. 2019;74: 104–132. doi:10.1016/j.jacc.2019.01.011
[13] Dominguez F, Climent V, Zorio E, Ripoll-Vera T, Salazar-Mendiguchía J, García-Pinilla JM, et al. Direct oral anticoagulants in patients with hypertrophic cardiomyopathy and atrial fibrillation[J]. Int J Cardiol. 2017;248: 232–238. doi:10.1016/j.ijcard.2017.08.010
[14] Wang KL, Lip GYH, Lin SJ, Chiang CE. Non-Vitamin K Antagonist Oral Anticoagulants for Stroke Prevention in Asian Patients with Nonvalvular Atrial Fibrillation: Meta-Analysis[J]. Stroke. 2015;46: 2555–2561. doi:10.1161/STROKEAHA.115.009947
[15] Jung H, Yang P-S, Jang E, Yu HT, Kim T-H, Uhm J-S, et al. Effectiveness and Safety of Non-Vitamin K Antagonist Oral Anticoagulants in Patients With Atrial Fibrillation With Hypertrophic Cardiomyopathy: A Nationwide Cohort Study[J]. Chest. 2019;155: 354–363. doi:10.1016/j.chest.2018.11.009
[16] Dominguez F, Climent V, Zorio E, Ripoll-Vera T, Salazar-Mendiguchía J, García-Pinilla JM, et al. Direct oral anticoagulants in patients with hypertrophic cardiomyopathy and atrial fibrillation[J]. Int J Cardiol. 2017;248: 232–238. doi:10.1016/j.ijcard.2017.08.010
Copyright © 2020 黄尚玮, 张 奇, 李纪明
Publishing time:2020-06-24
This work is licensed under a Creative Commons Attribution 4.0 International License
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