Metwally Omar H, Rahhal Alaa, Elsherif Raghad A, Elshoeibi Ahmed M, Elhadary Mohamed, Elshoeibi Amgad M, Badr Ahmed, Elsayed Basel, Al-Rasheed Mona, Alshurafa Awni, Yassin Mohamed A
College of Medicine, QU Health, Qatar University, Doha, Qatar.
Pharmacy Department, Heart Hospital, Hamad Medical Corporation (HMC), Doha, Qatar.
Int J Cardiol Heart Vasc. 2024 Aug 22;54:101493. doi: 10.1016/j.ijcha.2024.101493. eCollection 2024 Oct.
This review aimed to assess bleeding risks and explore management options in atrial fibrillation (AF) patients with immune thrombocytopenia (ITP), aiming to formulate an optimal therapeutic approach for improved patient prognosis. Employing MeSH terms, a comprehensive search strategy identified articles on bleeding risks and management guidelines in AF combined with ITP. Original research papers were included, while animal studies, reviews, and non-English articles were excluded. From four databases, 1891 articles were initially retrieved, resulting in 10 relevant full-text articles. Eight studies investigated the effectiveness of anticoagulants in managing concurrent AF and ITP, demonstrating reduced bleeding risk and promising outcomes. Two papers explored surgical interventions, particularly left atrial appendage closure, suggesting its safety for AF management in patients with primary hemostatic disorders, including thrombocytopenia. While the pathophysiological mechanisms of AF and ITP remain unclear, anticoagulation regimens exhibited promising reductions in bleeding risks. Larger studies are warranted to enhance understanding and investigate optimal treatments for AF and ITP.
本综述旨在评估免疫性血小板减少症（ITP）合并心房颤动（AF）患者的出血风险并探索管理方案，旨在制定优化治疗方法以改善患者预后。采用医学主题词（MeSH），全面检索策略确定了关于AF合并ITP出血风险和管理指南的文章。纳入原创研究论文，排除动物研究、综述和非英文文章。从四个数据库中，最初检索到1891篇文章，最终得到10篇相关全文文章。八项研究调查了抗凝剂在管理AF合并ITP方面的有效性，显示出血风险降低且结果良好。两篇论文探讨了手术干预措施，特别是左心耳封堵术，表明其对包括血小板减少症在内的原发性止血障碍患者进行AF管理是安全的。虽然AF和ITP的病理生理机制尚不清楚，但抗凝方案在降低出血风险方面显示出良好前景。需要开展更大规模的研究以增进了解并探索AF和ITP的最佳治疗方法。
