艾布西西玛布在患有急性ST段升高心肌梗塞的患者中,在克洛皮多格雷尔加载后接受初级皮肤冠状动脉干预:一项随机双盲试验
Julinda Mehilli1, Adnan Kastrati, Stefanie Schulz
1Deutsches Herzzentrum, Technische Universität, Munich, Germany. mehilli@dhm.mhn.de
Circulation
|April 1, 2009
概括
将abciximab添加到clopidogrel并没有减少ST段升高心肌梗塞患者的心脏病发作的大小. 这项研究发现,阿布西西马布使用的重大不良事件或出血并发症没有显著的益处.
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:
- 作为一种糖蛋白IIb/IIIa受体抑制剂的Abciximab可增强急性心肌梗塞的初级皮肤冠状动脉干预措施.
- 在ST段升高心肌梗塞 (STEMI) 中,在克洛皮多格雷尔加重后使用abciximab的益处尚不清楚.
研究的目的:
- 为了确定abciximab是否改善了已经接受了clopidogrel治疗的STEMI患者的结果.
- 评估abciximab对心脏病发作大小和主要心脏不良事件的影响.
主要方法:
- 在症状发作的24小时内,800名STEMI患者,所有人都服用600毫克克洛皮多格雷尔,随机分配给abciximab或安慰剂.
- 在出院前使用技术-99m sestamibi 测量了心脏病发作的大小.
- 在30天后追踪死亡,复发性心脏病发作,中风或紧急再血管化的综合情况.
主要成果:
- 在abciximab组中,平均心脏病发作大小为15.7%,而在安慰剂组中为16.6% (P=0.47).
- 综合终点发生在abciximab组的5.0%和安慰剂组的3.8% (P=0.40).
- 在两组患者中,主要出血并发症发生在1.8%的患者中.
结论:
- 在接受600毫克克洛皮多格雷尔的STEMI患者中,上游的abciximab管理并没有减少心脏病发作的大小.
- 在该患者群体中,abciximab在减少重大不良事件或增加出血风险方面没有显著的益处.
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