在非ST升高急性冠状动脉综合征 (FRISC-II) 患者中,早期的侵入性治疗与非侵入性治疗:前性,随机化,多中心研究的15年随访
Lars Wallentin1, Lars Lindhagen2, Elisabet Ärnström2
1Department of Medical Sciences, Cardiology, Uppsala University, Uppsala, Sweden; Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden.
Lancet (London, England)
|September 3, 2016
概括
在15年内,早期的侵袭策略显著减少了非ST升高急性冠状动脉综合征患者的死亡或心肌梗塞. 这种方法对非吸烟者和生物标志物升高的人特别有益,延缓心血管事件.
科学领域:
- 心脏病学
- 临床试验
- 急性冠状动脉综合征
背景情况:
- 在FRISC-II试验中,针对非ST升高急性冠状动脉综合征 (NSTE-ACS) 确定了早期侵入性治疗的益处.
- 这一策略在患者余生中的长期结果以前是未知的.
研究的目的:
- 评估早期入侵与非入侵策略对NSTE- ACS患者所有心血管事件的长期 (15年) 影响.
- 提供治疗疗效的余生前景.
主要方法:
- 这是一项前性随机多中心试验,涉及2457名NSTE-ACS患者.
- 早期侵入性策略 (在7天内进行再血管) 与非侵入性策略的比较.
- 长期跟踪数据与国家健康登记相关,结果按治疗意图进行分析.
主要成果:
- 侵袭性策略将死亡或下一次心肌梗塞推迟了平均549天 (p=0. 0020) 超过15年.
- 这种延期在非吸烟者,高托罗邦素T患者和高增长差异化因子-15患者中显著增加.
- 侵袭性策略还将缺血性心脏病的再入院推迟了平均1128天 (p<0.0001).
结论:
- 在NSTE-ACS患者中,早期的侵入性策略在延迟重大心血管不良事件和再入院方面具有显著的长期益处.
- 这些发现支持早期侵入性策略作为大多数NSTE-ACS患者的首选治疗方案.
- 小组分析突出了这种方法最受益的特定患者群体.
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