利伐沙班与依诺肝素加氯吡格雷疗法治疗猫肥厚型心肌病相关血栓栓塞症

Kotchapol Jaturanratsamee, Palin Jiwaganont, Chattida Panprom, S. Petchdee
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背景和目的:心源性栓塞(CE)是猫肥厚型心肌病(HCM)的常见并发症,会导致严重的临床症状。本研究比较了利伐沙班和依诺肝素联合氯吡格雷对猫的影响:这是一项单中心、前瞻性、随机对照试验。在这项研究中,利伐沙班或依诺肝素联合氯吡格雷被用于 23 只至少发生以下一种情况的猫:二尖瓣前叶在收缩期出现异常运动、左心房扩大、自发性超声心动图对比或出现动脉血栓栓塞。为六只猫口服利伐沙班(2.5 毫克,24 小时一次)。17 只猫皮下注射依诺肝素(1 毫克/千克,q24 小时)加口服氯吡格雷(3 毫克/千克,PO q24 小时),持续 60 天。观察到了肾功能不全和出血并发症。评估了血浆中 D-二聚体、凝血酶原时间(PT)、部分凝血活酶时间和国际标准化比值(INR)的浓度。我们分析了超声心动图参数与凝血作用之间的关系。我们采集了所有猫在基线期和治疗后 1 个月和 2 个月的血样:结果:单独使用利伐沙班或与依诺肝素和氯吡格雷联合使用利伐沙班都会显著影响 PT 和 INR。在使用 2.5 mg/kg 利伐沙班治疗 60 天的猫中,没有观察到出血或血栓形成复发。这些数据支持使用利伐沙班治疗猫 HCM 相关血栓栓塞症:单用利伐沙班治疗猫 HCM 相关血栓栓塞症临床疗效显著,且无临床并发症。
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Rivaroxaban versus enoxaparin plus clopidogrel therapy for hypertrophic cardiomyopathy-associated thromboembolism in cats
Background and Aim: Cardiogenic embolism (CE) is a common complication of feline hypertrophic cardiomyopathy (HCM), leading to severe clinical symptoms. This study compared the effects of rivaroxaban and enoxaparin combined with clopidogrel on cats. Materials and Methods: This was a single-center, prospective, randomized controlled trial. In this study, rivaroxaban or enoxaparin plus clopidogrel was prescribed to 23 cats for at least one of the following events: Abnormal movement of the anterior mitral leaflet during systole, enlargement of the left atrium, spontaneous echocardiographic contrast, or presence of arterial thromboembolism. Oral rivaroxaban (2.5 mg, q24 h) was prescribed to six cats. Subcutaneous injections of enoxaparin (1 mg/kg, q24 h) plus oral clopidogrel (3 mg/kg, PO q24 h) for 60 days were administered to 17 cats. Renal insufficiency and bleeding complications were observed. Plasma concentrations of D-dimer, prothrombin time (PT), partial thromboplastin time, and international normalized ratio (INR) were evaluated. We analyzed the relationship between echocardiography parameters and the effects of coagulation. Blood samples were collected from all cats at baseline and at 1 and 2 months post-treatment. Results: Rivaroxaban alone and in combination with enoxaparin and clopidogrel significantly affected PT and INR. In cats treated with 2.5 mg/kg rivaroxaban for 60 days, no bleeding or recurrence of thrombus formation was observed. These data support the use of rivaroxaban for the treatment of HCM-associated thromboembolism in cats. Conclusion: Treatment of HCM-associated thromboembolism with rivaroxaban alone demonstrated clinical effectiveness with no clinical complications in cats. Keywords: cardiomyopathy, D-dimer, echocardiography, prothrombin time.
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