克洛皮多格勒的使用和药物释放支架植入后的长期临床结果
Eric L Eisenstein1, Kevin J Anstrom, David F Kong
1Department of Medicine, Duke Clinical Research Institute, Duke University Medical Center, Durham, NC 27710, USA. eric.eisenstein@duke.edu
JAMA
|December 7, 2006
概括
在具有药物排泄支架 (DES) 的患者中,延长使用克洛皮多格雷尔可能会降低死亡和心肌梗塞 (MI) 的风险. 然而,最佳持续时间需要在临床试验中进一步研究.
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:
- 目前的抗血小板疗法可能不足以预防药物释放支架 (DES) 植入后的晚期支架血栓形成.
- 需要进行观察性研究来评估与冠状动脉疾病患者使用冠状动脉支架治疗的抗血小板药物相关的长期结果.
研究的目的:
- 评估克洛皮多格雷尔使用与接受药物释放支架 (DES) 与裸金属支架 (BMS) 的患者的长期临床结果之间的关联.
- 为了确定使用克洛皮多格雷尔是否会影响支架植入后的死亡率和心肌梗塞 (MI).
主要方法:
- 一项对4666名通过皮肤冠状动脉干预接受BMS或DES的患者的观察性研究.
- 在手术后6个月和12个月进行了里程碑式分析,根据支架类型和克洛皮多格雷尔使用情况对患者进行了分类.
- 评估的结果包括死亡,非致命性心脏病发作,以及24个月随访时的死亡或心脏病发作的综合结果.
主要成果:
- 在 DES 患者中,在 6 个月后无事件,使用克洛皮多格雷尔与 24 个月后死亡和死亡或心脏病发作率显著降低有关.
- 在BMS患者中,在6个月后没有事件,在使用克洛皮多格雷尔时,没有观察到死亡或死亡或MI的显著差异.
- 在对12个月无事件患者的分析中观察到类似的发现,在DES患者中使用克洛皮多格雷尔预测了较低的死亡率和死亡率或心脏病发作率.
结论:
- 在患有DES的患者中,延长使用克洛皮多格雷尔可能与死亡和死亡或心脏病发作风险降低有关.
- 克洛皮多格雷尔的最佳持续时间需要通过大规模随机临床试验来确定.
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