克洛皮多格雷尔在患有急性冠状动脉综合征而没有ST段升高的患者中的益处在各种风险组中
Andrzej Budaj1, Salim Yusuf, Shamir R Mehta
1Postgraduate Medical School, Grochowski Hospital Warsaw, Poland.
Circulation
|September 25, 2002
概括
克洛皮多格勒在急性冠状动脉综合征患者中显著减少心血管事件. 这一好处在低,中,高风险群体中是一致的,支持其在非ST升高ACS中的使用.
科学领域:
- 心脏病学 心脏病学
- 临床试验 临床试验
- 药理学 药理学是指药理学的学科.
背景情况:
- 克洛皮多格雷尔在不稳定性胸痛中预防复发事件 (CURE) 试验证实了克洛皮多格雷尔在非ST升高急性冠状动脉综合征 (NSTE-ACS) 中比安慰剂优越.
- 阿司匹林与克洛皮多格雷尔或安慰剂同时使用.
研究的目的:
- 基于对未来心血管事件的患者风险分层来评估克洛皮多格雷尔的治疗效果.
- 在CURE试验人群中分析克洛皮多格雷尔在不同风险类别中的疗效.
主要方法:
- 12,562名在症状发作后24小时内出现的患者被随机分类.
- 患者接受了克洛皮多格雷尔 (300毫克负载,每天75毫克) 或安慰剂,加上阿司匹林,持续3-12个月.
- 用心肌梗塞中血栓溶解 (TIMI) 风险评分来分析治疗效应.
主要成果:
- 心肌梗塞中血栓溶解 (TIMI) 风险模型在CURE人群中得到了验证.
- 主要综合结局 (心血管死亡,心肌梗塞,中风) 与TIMI风险得分增加.
- 克洛皮多格勒在各个风险组中显著降低了风险:低风险 (RR 0.71),中等风险 (RR 0.85) 和高风险 (RR 0.73).
结论:
- 克洛皮多格雷尔对患有急性冠状动脉综合征的患者提供了一致的益处,无论他们的心血管风险如何.
- 这些发现支持在所有被诊断为非ST升高急性冠状动脉综合征的患者中使用克洛皮多格雷尔.
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