在冠状动脉旁路移植手术后,他类药物的使用对冠状动脉旁路移植手术后的结果的影响
Alexander Kulik1, M Alan Brookhart, Raisa Levin
1Brigham and Women's Hospital, 1620 Tremont St, Suite 3030, Boston, MA 02120, USA.
Circulation
|October 15, 2008
概括
在冠状动脉旁路移植 (CABG) 后早期的他类药物治疗显著降低了死亡率和主要的不良心血管事件. 在手术后一个月内开始服用他类药物对于改善患者的治疗结果至关重要.
科学领域:
- 心血管医学 心血管医学
- 药理学 药理学是指药理学的学科.
- 健康 结果 研究 研究 结果
背景情况:
- 对于先前冠状动脉旁路移植 (CABG) 患者,他类药物的确立益处.
- 缺乏关于CABG后早期使用他类药物的研究和临床结果的研究.
研究的目的:
- 评估早期启动他类药物治疗对CABG后临床结果的影响.
- 为了比较CABG后早期和延迟的他类药物开始之间的结果.
主要方法:
- 在7503名65岁以上的医疗保险患者中进行了回顾性队列研究,这些患者接受了CABG (1995-2003).
- 对相关的医院和药房索赔数据的分析.
- 在退院后1个月内,以及在早期 (<=1个月) 和延迟 (1-6个月) 开始之间,对他类药物使用者和不使用者之间的死亡率和主要不良心血管事件 (MACE) 的比较.
主要成果:
- 在CABG释放1个月内使用静止剂独立降低了全因死亡率 (aHR 0.82) 和MACE (aHR 0.89).
- 延迟使用他类药物 (CABG后1-6个月) 也显示了MACE和死亡率的降低.
- 早期和延迟开始使用他类药物组之间的结果没有显著差异.
结论:
- 在CABG后早期启动他类药物治疗独立降低死亡率和MACE.
- 这些发现支持目前的做法,即在CABG后处方长期的他类药物治疗.
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