1 Department of Pharmacy Practice, South Dakota State University, Sioux Falls, SD, USA.
2 Department of Pharmacy, Avera McKennan Hospital, Sioux Falls, SD, USA.
J Cardiovasc Pharmacol Ther. 2019 Jan;24(1):31-36. doi: 10.1177/1074248418783745. Epub 2018 Jun 18.
In 2 distinct entities, left ventricular noncompaction (LVNC) and peripartum cardiomyopathy (PPCM), routine anticoagulation therapy is often used in current practices. However, our systematic review showed that LVNC itself was not associated with the increase in thromboembolism event rates and therapeutic anticoagulation therapy should not be considered only for LVNC, unless there is risk factor for thromboembolism. Current literature justifies prophylactic therapeutic anticoagulation in LVNC with low left ventricular ejection fraction (EF < 40%) and/or atrial fibrillation. Although not specifically studied, the presence of intracardiac thrombi by echocardiography or other imaging studies should also prompt anticoagulation therapy. There is limited evidence available for the use of anticoagulation in patients with PPCM, but our systematic review showed that anticoagulation should be recommended only for patients with PPCM especially with an EF < 35% until EF is recovered, as well as for patients with PPCM treated with bromocriptine.
在左心室心肌致密化不全（LVNC）和围生期心肌病（PPCM）这两个不同的实体中，目前的常规治疗常采用抗凝治疗。然而，我们的系统评价表明，LVNC 本身并不增加血栓栓塞事件的发生率，不应仅因 LVNC 而考虑进行治疗性抗凝治疗，除非存在血栓栓塞的危险因素。目前的文献证明，对于左心室射血分数（EF<40%）和/或心房颤动较低的 LVNC 患者，预防性治疗性抗凝是合理的。尽管没有专门研究，但超声心动图或其他影像学检查发现心内血栓也应提示抗凝治疗。对于 PPCM 患者使用抗凝治疗的证据有限，但我们的系统评价表明，仅应推荐 EF<35%的 PPCM 患者以及接受溴隐亭治疗的 PPCM 患者使用抗凝治疗，直至 EF 恢复。
