冠動脈ステント移植後の医療管理: レビュー
Emmanouil S Brilakis1, Vishal G Patel, Subhash Banerjee
1VA North Texas Health Care System and University of Texas Southwestern Medical Center at Dallas, Dallas, TX 75216, USA. emmanouil.brilakis@va.gov
JAMA
|July 11, 2013
まとめ
経皮冠動脈介入 (PCI) の後の最適な治療法は,アスピリンとP2Y12阻害剤を併用したダブル抗血小板療法 (DAPT) を12ヶ月間行うことです. DAPTは,PCIを受けた患者のステントの血栓形成と心血管疾患の減少に不可欠です.
科学分野:
- 心臓病学 心臓病学
- 薬理学 薬理学とは
- 介入性心臓病学 介入性心臓病学
背景:
- ステント付きの皮膚経冠動脈介入 (PCI) は,一般的な再血管化処置である.
- PCI後のアウトカムを最適化することは,患者管理において極めて重要です.
研究 の 目的:
- PCI後の最適な医療療法に関する現在の文献をレビューする.
- PCI後の薬剤療法について,根拠に基づいた勧告を提供すること.
主な方法:
- パブメドとコクラン図書館 (2000〜2013) の包括的な文献検索.
- ランダム化比較試験,システマティックレビュー,メタアナリシスを含む.
- 手作業で検索した研究論文の資料集.
主要な成果:
- アスピリンとP2Y12阻害剤による二重抗血小板療法 (DAPT) が標準的な治療法であり,ステントの血栓形成と心血管疾患を軽減します.
- アスピリンは無期限で,P2Y12阻害剤は12ヶ月間,最適な期間に関する研究が進行中です.
- より新しいP2Y12阻害剤 (プラスグレル,チカグレル) は,急性冠動脈症候群において,より大きな缺血事件の減少を提供するが,出血リスクを増加させる.
結論:
- 二重抗血小板治療は,PCI後の医療管理の礎となっている.
- 薬剤療法における進歩は,高リスクのPCI患者のアウトカムを改善し続けています.
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