在接受心脏外科手术的患者中,将抗血小板治疗与康格罗尔结合起来:一种随机对照试验
Dominick J Angiolillo1, Michael S Firstenberg, Matthew J Price
1Department of Cardiology, University of Florida, Jacksonville, USA.
JAMA
|January 19, 2012
概括
康格洛尔在停止使用烯胺剂后接受冠状动脉旁路移植 (CABG) 手术的患者中有效维持了血小板抑制. 这种静脉注射治疗提供了一个安全的桥梁选择,没有显著增加重大出血事件.
科学领域:
- 心脏病学 心脏病学
- 药理学 药理学是指药理学的学科.
- 临床试验 临床试验
背景情况:
- 诺皮里丁通常被处方,但在需要手术时会带来挑战.
- 指导方针建议在手术前5-7天停止服用丁胺,以减轻出血风险,尽管血栓形成风险增加.
研究的目的:
- 评估康格罗尔,一种IV可逆P2Y12抑制剂,作为在等待冠状动脉旁路移植 (CABG) 的tionopyridines患者的桥梁疗法.
主要方法:
- 一项前性,随机,双盲,安慰剂控制的多中心试验,涉及210名正在接受或等待CABG的患者.
- 患者在停止服用丁诺皮里丁后接受了康格罗尔或安慰剂,在手术前1-6小时停止治疗.
主要成果:
- 与安慰剂相比,Cangrelor显著增加了实现低血小板反应率 (PRU <240) 的患者比例 (98.8% vs 19.0%).
- 过度出血的发病率在两组之间相似 (11.8%的草 vs 10.4%的安慰剂),在重大出血方面没有显著差异.
- 轻微出血发作在数量上更高,但在统计学上不显著.
结论:
- 康格洛尔有效地保持血小板抑制在心脏手术前停止丁二林治疗的患者.
- 它作为一个可行的桥梁策略,在CABG的背景下,在重大出血方面证明了与安慰剂相比的安全性.
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