库马林在冠状动脉动脉形成手术前开始对急性并发症和长期随访的影响:一项随机试验
J M ten Berg1, J C Kelder, M J Suttorp
1Department of Interventional Cardiology, St Antonius Hospital, Nieuwegein, The Netherlands. jurtenberg@wxs.nl
Circulation
|July 25, 2000
概括
在穿皮冠状动脉干预 (PCI) 之前将库马林添加到阿司匹林中,并持续六个月,显著减少了急性和晚期并发症. 然而,这种方法与出血事件略有增加有关.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 药理学 药理学是指药理学的学科.
背景情况:
- 冠状动脉血管造形术可以创建血栓形成的表面,导致壁膜血栓,急性并发症和静脉复缩.
- 库马林在预防这些血管形成术后并发症的疗效尚不清楚.
- 这项研究调查了手术前马林启动的临床影响.
研究的目的:
- 评估在冠状动脉血管塑造手术前开始并持续六个月的库马林的临床有效性.
- 评估通过皮肤冠状动脉干预 (PCI) 后的急性和晚期并发症的预防.
主要方法:
- 一个开放标签的随机试验,涉及1058名接受冠状动脉血管塑性手术的患者.
- 患者被分配给接受阿司匹林加上库马林或单独服用阿司匹林.
- 随访包括对复合终点,出血和假动脉瘤的监测.
主要成果:
- 阿司匹林加库马林组在30天 (3.4%对6.4%) 和1年 (14.3%对20.3%) 的时间里显著减少了死亡,心肌梗塞,目标损伤再血管化和中风的复合终点.
- 无论是用支架还是没有支架的患者,都观察到益处.
- 住院期间严重出血和虚假动脉瘤发生率增加 (3.2%对1.0%).
结论:
- 与阿司匹林结合的库马林,在PCI之前开始并持续六个月,在预防早期和晚期并发症方面比单独的阿司匹林更有效.
- 观察到的好处伴随着出血并发症的统计学上显著但小幅增加.
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