阿司匹林和提克洛皮丁用于预防黑人患者中风复发:一项随机试验
Philip B Gorelick1, DeJuran Richardson, Michael Kelly
1Department of Neurologic Sciences, Rush Medical College, Chicago, IL 60612, USA. Philip_B_Gorelick@rush.edu
JAMA
|June 12, 2003
概括
在黑人患者中,阿司匹林和提克洛皮丁在预防复发性中风,心肌梗塞或血管死亡方面没有显著差异. 阿司匹林显示出减少中风的趋势,并且由于提克洛皮丁,它被认为是更好的选择.
科学领域:
- 神经学 神经学
- 心脏病学 心脏病学
- 临床试验 临床试验
背景情况:
- 与美国其他人口相比,黑人患中风的比例不成比例地高.
- 在黑人中,中风的死亡率和发病率大约是黑人的两倍.
研究的目的:
- 评估阿司匹林与提克洛皮丁在预防黑人患者中风的有效性和安全性.
- 为了比较这些抗血小板剂在高风险人口中的有效性.
主要方法:
- 一个随机的,双盲的多中心试验,涉及1809名黑人参与者,最近患有非心血管血性缺血性中风.
- 参与者被分配接受提克洛皮丁 (500毫克/天) 或阿司匹林 (650毫克/天) 长达2年.
- 主要终点是复发性中风,心肌梗塞或血管死亡的组合.
主要成果:
- 该研究因徒劳而提前停止;在提克洛皮丁和阿司匹林组之间的初级结果中没有发现统计学上显著的差异 (14.7%与12.3%,P=.12).
- 一个不显著的趋势有利于阿司匹林对于致命或非致命性中风的二次结果 (P=.08).
- 严重的中性缺血发生在3.4%的提克洛皮丁接受者,而2.2%的阿司匹林接受者 (P=.12).
结论:
- 提克洛皮丁和阿司匹林都没有在2年内在预防复发性中风,心肌梗塞或血管死亡方面表现出统计学上显著的优势.
- 阿司匹林显示出减少中风的趋势,并且被认为是阿司匹林耐受性非心血管栓塞性缺血性中风的黑人患者的首选治疗方法,考虑到蒂克洛皮丁的不良事件概况.
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