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排序方式: 共有2105条查询结果,搜索用时 15 毫秒
1.
《JACC: Cardiovascular Interventions》2022,15(7):741-750
ObjectivesThe aim of this study was to report 1-year clinical outcomes following commercial transcatheter left atrial appendage occlusion (LAAO) in the United States.BackgroundThe National Cardiovascular Data Registry LAAO Registry was initiated to meet a condition of Medicare coverage and allow the assessment of clinical outcomes. The 1-year rates of thromboembolic events after transcatheter LAAO in such a large cohort of “real-world” patients have not been previously reported.MethodsPatients entered into the National Cardiovascular Data Registry LAAO Registry for a Watchman procedure between January 1, 2016, and December 31, 2018, were included. The primary endpoint was ischemic stroke. Key secondary endpoints included the rate of ischemic stroke or systemic embolism, mortality, and major bleeding. Major bleeding was defined as any bleeding requiring hospitalization, and/or causing a decrease in hemoglobin level > 2g/dL, and/or requiring blood transfusion that was not hemorrhagic stroke. The Kaplan-Meier method was used for 1-year estimates of cumulative event rates.ResultsThe study population consisted of 36,681 patients. The mean age was 76.0 ± 8.1 years, the mean CHA2DS2-VASc score was 4.8 ± 1.5, and the mean HAS-BLED score was 3.0 ± 1.1. Prior stroke was present in 25.5%, clinically relevant bleeding in 69.5%, and intracranial bleeding in 11.9%. Median follow-up was 374 days (IQR: 212-425 days). The Kaplan-Meier–estimated 1-year rate of ischemic stroke was 1.53% (95% CI: 1.39%-1.69%), the rate of ischemic stroke or systemic embolism was 2.19% (95% CI: 2.01%-2.38%), and the rate of mortality was 8.52% (95% CI: 8.19%-8.87%). The 1-year estimated rate of major bleeding was 6.93% (95% CI: 6.65%-7.21%). Most bleeding events occurred between discharge and 45 days following the procedure.ConclusionsThis study characterizes important outcomes in a national cohort of patients undergoing transcatheter LAAO in the United States. Clinicians and patients can integrate these data in shared decision making when considering this therapy. 相似文献
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Guerard W. Byrne Johannes M. Schirmer David N. Fass Sumeet S. Teotia Walter K. Kremers Hui Xu Bashoo Naziruddin Henry D. Tazelaar John S. Logan Christopher G. A. McGregor 《American journal of transplantation》2005,5(5):1011-1020
Microvascular thrombosis is a prominent feature in cardiac delayed xenograft rejection (DXR). We investigated the impact of warfarin or low-molecular-weight heparin (LMWH) anti-coagulation on xenograft function using a heterotopic pig-to-primate model. Donor hearts were from CD46 transgenic pigs and baboon immunosuppression included tacrolimus, sirolimus, anti-CD20 and TPC, an alpha-galactosyl-polyethylene glycol conjugate. Three groups of animals were studied. Group 1 (n = 9) was treated with warfarin, Group 2 (n = 13) with LMWH and Group 3, received no anti-coagulant drugs. The median duration of xenograft function was 20 days (range 3-62 days), 18 days (range 5-109 days) and 15 days (range 4-53 days) in Groups 1 to 3 respectively. Anti-coagulation achieved the targeted international normalized prothrombin ratio (INR) and anti-factor Xa levels consistent with effective in vivo therapy yet, no significant impact on median xenograft function was observed. At rejection, a similar histology of thrombosis and ischemia was apparent in each group and the levels of fibrin deposition and platelet thrombi in rejected tissue was the same. Anti-coagulation with warfarin or LMWH did not have a significant impact on the onset of DXR and microvascular thrombosis. However, a role for specific anti-coagulant strategies to achieve long-term xenograft function cannot be excluded. 相似文献
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Objective:To explore the effect of thrombolysis with anticoagulation treatment forearly stage of deep vein thrombosis of lower extremity.Methods:The clinical data of 10 patients at the early stage of deep vein thrombosis(DVT)in the lower extremuites treated by thrombolysis with anticoagulation and dispersion drugs were analyzed retrospectively.Results:The thrombolytic effect was significant.After treatment,the deep veins were recanalized without regurgitation in 75.3% of the patients.The total effective rate was 100%.Only three patients had hemorrhagic complication,but none of the patients died.Conclusion:Thrombolysis with anticoagulation treatment is an effective and safe method for DVT at the early stage. 相似文献
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Angelika Bernardo M. D. 《Journal of thrombosis and thrombolysis》1996,2(4):321-325
Long-term oral anticoagulation requires careful patient monitoring in order to optimize results and to limit hemorrhagic or thromboembolic complications of treatment. For this reason, any improvement in anticoagulant control and management can be expected to have far-reaching consequences in extending longevity and decreasing complications in anticoagulated patients after heart valve surgery. Because one attractive means of improving anticoagulant management is to give patients a share of the responsibility, a program was designed to encourage patients to take an active role in monitoring their own prothrombin time (PT) and managing their own oral anticoagulation. During the period from August 1986 to February 1992, 600 patients requiring long-term anticoagulation, mainly after heart valve replacement, were trained to measure their own PT at the Cardiac Rehabilitation Center (Herz-Krauslauf-Klinik, Bad Berleburg, Germany) and to manage their own therapy: 216 patients could be followed with regard to their self-determined prothrombin times. The results were within the target range in 83.1% of the PT determinations (n=12,306 measurements) taken by the patients themselves. Neither major bleeding nor thromboembolic complications were observed in 205 patient-years of self-monitoring of PT and self-management of oral anticoagulation. 相似文献
6.
R. I. Parker 《Intensivmedizin und Notfallmedizin》1997,34(1):24-32
Summary Excessive bleeding frequently complicates the care of critically-ill patients. Except in the case of trauma or in patients
with known coagulopathies (e.g., hemophilia), the bleeding is generally not directly related to the illness that results in
admission to the intensive care unit. In general, the causes of the bleeding can be divided into 3 categories: consumptive
coagulopathies (e.g., DIC), bleeding related to ``hepatic issues' (i.e., liver dysfunction, vitamin K deficiency), and iatrogenic
causes. This review will discuss the more common causes of bleeding in the critically-ill patient and outline diagnostic and
treatment approaches for these patients. New experimental data linking activation of the coagulation and inflammatory systems
with the development of multisystem organ failure is briefly discussed.
Received: 8 November 1996 Accepted: 18 November 1996 相似文献
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Ping-Yang Hong Mao-Hong Huang An-Ke Hu Yan-Ting Lai Hui-Qing Zeng Xiao-Bin Zhang 《Medicine》2022,101(37)
In patients with coronavirus disease 2019 (COVID-19), anticoagulation was suggested as a mitigating strategy. However, little research has been conducted on the adverse consequences of anticoagulant medication. This study aimed to investigate the adverse effect of low molecular weight heparin (LMWH) on hemoglobin fall in COVID-19 treatment. The electronic medical records of COVID-19 patients with pneumonia were collected (including clinical characteristics, vaccination status, complete blood count, coagulation profile, inflammatory cytokines, serum biochemical indicators, and computerized tomography imaging score). Whether they received LMWH, patients were divided into the LMWH group and the control group. Count data were represented as frequency distribution, and a 2-tailed test was used to compare the 2 groups. Spearman rank correlation was used to evaluate the interrelation between changes in hemoglobin and LMWH. The confounding factors were excluded by logistic regression analysis. A total of 179 COVID-19 pneumonia patients were enrolled (81 in the LMWH group and 98 in the control group). The change in hemoglobin was −6.0g/L (IQR −10.8 to 1.0) in the LMWH group and −2.0g/L (IQR −7.0 to 4.0) in the control group (P < .001, between-group difference, −5.0 g/L; 95% confidence interval, −7.0 to −3.0, calculated with the use of the Mann–Whitney U test and the Hodges–Lehmann estimate of confidence intervals for pseudo-medians). The results of multivariate regression analysis showed that after adjusting for confounding factors, LMWH use was not associated with a decrease in hemoglobin (P > .05). In nonsevere COVID-19 patients with pneumonia, the preventive use of LMWH did not lower hemoglobin. 相似文献
10.
天麻糖蛋白的抗凝与抗栓作用 总被引:7,自引:0,他引:7
目的:观察天麻糖蛋白(PGE2-1)的抗血凝与抗血栓作用。方法:玻片法、减尾法检测小鼠凝血时间(CT)和出血时间(BT);减尾测5 min后的出血量吸光度(A540);小鼠体内测定血浆复钙时间(RT);ADP诱导血小板聚集(PAG);试剂盒测定血浆凝血酶原时间(PT)、凝血酶时间(TT)、部分凝血活酶时间(APTT);体外血栓仪测定大鼠体外形成血栓的长度、湿重、干重;实验性动静脉旁路血栓模型测定血栓的湿重及PGE2-1对其的抑制率。结果:60,120 mg·kg-1的PGE2-1能显著延长小鼠的凝血时间、出血时间,增大出血量(A540)(P<0.05或P<0.01)。30,60,120 mg·kg-1的PGE2-1能延长小鼠血浆复钙时间,降低血小板聚集率(P<0.05或P<0.01)。10,20,40 mg·mL-1的PGE2-1能使TT和APTT显著延长(P<0.05或P<0.01),但对PT的影响无统计学意义。30,60,120 mg·kg-1的PGE2-1能使小鼠消除血栓症状、恢复自主活动时间明显缩短(P<0.05或P<0.01);使大鼠体外形成的血栓长度显著减短、湿重和干中显著减小(P<0.05或P<0.01);极显著减小大鼠实验性动脉血栓的湿重(P<0.01),各药物组抑制率分别为32.5%,49.0%和61.5%。结论:PGE2-1具有显著的抗凝、抗栓作用,可能为天麻提取物在抗栓方面的主要成分。 相似文献