クロピドグレル対チカグレルまたはプラスグレル 70歳以上の非ST上昇性急性冠動脈症候群 (POPular AGE) の患者: ランダム化,オープンラベル,非劣等性試験
PubMedで要約を見る
まとめ
この要約は機械生成です。高齢のST上昇のない急性冠動脈症候群 (NSTE- ACS) の患者では,クロピドグレルはチカグレロと比較して著しく少数の出血を引き起こした. この研究では,クロピドグレルは高齢者のための安全で効果的な代替薬であり,好ましい臨床効果を示した.
科学分野
- 心臓病科
- 臨床試験
- 薬理学について
背景
- 現在のガイドラインでは,急性冠動脈症候群後の強力なP2Y12阻害剤 (チカグレロ,プラスグレル) を推奨しています.
- 高齢患者における最適な抗血小板治療に関するデータは限られている.
- POPular AGE試験では,クロピドグレルとチカグレル/プラスグレルの比較を,高齢のNSTE- ACS患者で調査した.
研究 の 目的
- 70歳以上のNSTE- ACS患者におけるクロピドグレルとチカグレルまたはプラスグレルの安全性と有効性を比較する.
- この特定の高齢者集団における出血事件と臨床的利益を評価する.
主な方法
- 1002人のNSTE- ACS患者を対象としたオープンランダム化対照試験 (POPular AGE).
- 患者は,クロピドグレルまたはチカグレル/プラスグレルを12ヶ月間,ランダムに割り当てられました.
- 主要エンドポイント: 出血事件 (PLATO基準); 副主要エンドポイント: 純臨床効果 (死亡,心臓発作,脳卒中,出血)
主要な成果
- クロピドグレル群では,一次出血が著しく減少した (18%対24%,p=0. 02).
- クロピドグレルの純臨床効果はチカグレロに比べて劣らなかった (28%対32%,p=0. 03).
- 血液出血や呼吸不全が原因で,チカグレロール群の薬剤中止率が高かった (47%対22%).
結論
- クロピドグレルは,NSTE- ACSの高齢患者 (≥70歳) の場合,チカグレロールの好ましい代替品です.
- クロピドグレルは,純臨床効果を損なうことなく,出血を減少させる.
- クロピドグレルは,高血症のリスクのある高齢者に対して考慮すべきです.
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