通过皮肤冠状动脉干预后,他类药物的炎症和益处之间的关系
Albert W Chan1, Deepak L Bhatt, Derek P Chew
1Catheterization Laboratory, Department of Cardiology, Ochsner Clinic Foundation, 1514 Jefferson Highway, New Orleans, La 70121, USA. achan@ochsner.org
Circulation
|April 1, 2003
概括
在皮肤冠状动脉干预 (PCI) 之前的他类药物治疗显著降低了高炎症标志物患者的死亡率. 高灵敏度C反应蛋白 (hsCRP) 指导策略可以优化他类药物的使用,并改善PCI后的结果.
科学领域:
- 心脏病学 心脏病学
- 药理学 药理学 是一个学科.
- 生物化学 生物化学
背景情况:
- 类他类药物除了降脂之外,还具有抗炎和抗血栓性质.
- 新出现的证据表明,他类药物可能会减少皮肤冠状动脉干预 (PCI) 后早期不良事件.
- 炎症,他类药物使用和PCI结果之间的相互作用需要进一步调查.
研究的目的:
- 调查手术前炎症,他类药物使用和PCI后的临床结果之间的关系.
- 确定他类药物治疗是否会改变PCI患者高灵敏性C反应蛋白 (hsCRP) 的预后值.
主要方法:
- 对1552名接受PCI的患者进行前性随访,并进行例行手术前hsCRP测量.
- 对他类药物的使用,hsCRP水平,心肌梗塞 (MI) 周围手术和1年死亡率的分析.
- 多变量分析和倾向得分调整,以评估结果的独立预测因素.
主要成果:
- 用他类药物预治疗的患者的hsCRP水平较低,并降低了周围手术性心脏病发作率.
- 药前治疗与改善1年生存率有关,特别是在hsCRP水平最高的患者中.
- 在非他类药物使用者中,手术前hsCRP独立预测1年死亡或MI;在最高hsCRP四分位数中,他类药物预治疗是生存的独立预测因素.
结论:
- 在PCI前使用他类药物治疗显著降低了hsCRP水平升高的患者的死亡率.
- 以hsCRP水平为指导的策略可能会提高PCI患者的他类药物治疗的有效性.
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