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首页> 外文期刊>Circulation journal >Implication of Preoperative Existence of Atrial Fibrillation on Hemocompatibility-Related Adverse Events During Left Ventricular Assist Device Support
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Implication of Preoperative Existence of Atrial Fibrillation on Hemocompatibility-Related Adverse Events During Left Ventricular Assist Device Support

机译：左室辅助装置支持过程中心房颤动术前存在对血液相容性相关不良事件的影响

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Background: Hemocompatibility-related adverse events (HRAEs) are substantial issues in patients with left ventricular assist devices (LVADs). Atrial fibrillation (AF) is associated with worse prognosis in patients with heart failure (HF), but its effect on HRAEs following LVAD implantation remain uncertain. Methods?and?Results: Data from the Japanese Mechanically Assisted Circulatory Support registry of consecutive patients who received HeartMate II LVADs and were followed for 1 year were retrospectively reviewed. Among 190 patients, 23 had AF and 167 had sinus rhythm. The AF group had comparable baseline characteristics with the non-AF group except for their higher age (53 vs. 42 years, P0.001). Following LVAD implantation, most cases of AF (73%) persisted. Antiplatelet therapy, anticoagulation therapy, and LVAD speed following LVAD implantation were comparable between groups (P0.05 for all). The 1-year survival free from HRAEs was comparable between groups (83% vs. 76%, P=0.52). Event rates of the breakdown of HRAEs were comparable between groups except for a relatively higher rate of surgically managed pump thrombosis in the AF group (0.16 vs. 0.04, incidence rate ratio 3.75, 95% confidence interval 0.87–16.1, P=0.075). These trends still remained with propensity score-matched comparison. Conclusions: Existence of AF had no effect on the development of HRAEs following LVAD implantation. The need to aggressively treat AF before or after LVAD implantation needs further investigation.
机译：背景：与血液相容性相关的不良事件（HRAE）是左心室辅助装置（LVAD）患者的重大问题。心力衰竭（HF）患者的心房纤颤（AF）与更差的预后相关，但其对LVAD植入后对HRAE的影响尚不确定。方法和结果：回顾性分析了日本机械辅助循环支持登记系统中连续接受HeartMate II LVAD并随访1年的患者的数据。在190例患者中，有23例患有AF，167例具有窦性心律。除年龄较高外，AF组的基线特征与非AF组相当（53岁对42岁，P <0.001）。 LVAD植入后，大多数AF患者（73％）持续存在。两组之间的抗血小板治疗，抗凝治疗和LVAD植入后的LVAD速度是可比较的（所有P> 0.05）。两组之间无HRAE的1年生存率相当（83％对76％，P = 0.52）。房颤组的HRAE分解事件发生率可比，但房颤组的外科手术泵血栓形成率较高（0.16 vs. 0.04，发生率比3.75，95％置信区间0.87-16.1，P = 0.075）。这些趋势仍与倾向得分匹配的比较保持一致。结论：AF的存在对LVAD植入后HRAE的发生没有影响。 LVAD植入之前或之后需要积极治疗房颤需要进一步研究。

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