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Improvement of a Closed Chest Porcine Myocardial Infarction Model by Standardization of Tissue and Blood Sampling Procedures
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在患有不稳定冠状动脉综合征 (OPUS-TIMI 16) 试验的患者中,使用奥博菲班抑制口服糖蛋白IIb/IIIa.

C P Cannon1, C H McCabe, R G Wilcox

  • 1Brigham and Women's Hospital, Boston, MA 02115, USA. ccannon@rics.bwh.harvard.edu

Circulation
|July 13, 2000
PubMed
概括

奥尔博菲班并没有减少急性冠状动脉综合征和增加死亡率的心血管事件,但在接受皮肤冠状动脉干预的患者中显示出好处. 这项研究强调了口服糖蛋白IIb/IIIa抑制剂的风险和潜在益处.

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科学领域:

  • 心脏病学 心脏病学
  • 药理学 药理学 是一个学科.

背景情况:

  • 静脉注射的葡萄糖蛋白IIb/IIIa抑制剂可以改善急性冠状动脉综合征的结果.
  • 长时间的口服抑制糖蛋白IIb/IIIa可能进一步减少复发事件.

研究的目的:

  • 评估口服糖蛋白IIb/IIIa抑制剂orbofiban在患有急性冠状动脉综合征的患者中的疗效和安全性.
  • 评估不同剂量方案对心血管事件和死亡率的影响.

主要方法:

  • 一个大规模的,随机的,安慰剂对照试验,涉及10,288名急性冠状动脉综合征患者.
  • 患者接受了阿司匹林,并随机分配到安慰剂,固剂量博菲班 (50毫克每天两次),或30天的充满剂量疗法 (50毫克每天两次30天,然后30毫克每天两次).
  • 主要复合终点包括死亡,心肌梗塞,复发性缺血,紧急再血管或中风.

主要成果:

  • 该试验因50/30欧博菲班组30天死亡率增加而提前停止.
  • 在50/30组 (5.1%) 与安慰剂 (3.7%) 相比,10个月的总死亡率更高.
  • 在orbofiban组和安慰剂组之间没有观察到主要复合终点的显著差异. 大型出血事件增加了 orbofiban.

结论:

  • 定剂量奥博菲班没有减少主要心血管事件,并且与急性冠状动脉综合征患者广泛人群的死亡率增加有关.
  • 在接受皮肤冠状动脉干预的小组患者中观察到奥博菲班的潜在益处.
  • 该研究建议谨慎使用口服葡萄糖蛋白IIb/IIIa抑制剂,因为增加了出血风险和可能导致更高的死亡率.