用特卡格勒或普拉苏格勒治疗的ST段升高心肌梗塞患者的微血管损伤评估
Maarten A H van Leeuwen1,2, Nina W van der Hoeven1, Gladys N Janssens1
1Department of Cardiology, VU University Medical Center, Amsterdam, The Netherlands (M.A.H.v.L., N.W.v.d.H., G.N.J., H.E., A.N., J.S.L., G.A.d.W., A.C.v.R., R.N., N.v.R.).
Circulation
|December 28, 2018
概括
与普拉苏格勒相比,在ST升高心肌梗塞后,蒂卡格勒维持治疗没有显著减少冠状动脉微血管损伤. 这两种疗法在一个月后导致了类似的心脏病发作大小和微血管阻塞率.
科学领域:
- 心脏病学
- 药理学
- 干预心脏病学
背景情况:
- 在ST段升高心肌梗塞 (STEMI) 后,冠状动脉微血管损伤很常见,尽管成功进行了重血管化,但影响了患者的治疗结果.
- 提卡格勒可能增加腺水平,这表明它可能对微循环产生保护作用.
- 这项研究旨在比较Ticagrelor和Prasugrel在STEMI患者中预防微血管损伤.
研究的目的:
- 在初级穿皮冠状动脉干预 (PCI) 后的STEMI患者中,评估提卡格雷勒维持疗法是否能减少冠状动脉微血管损伤.
- 评估提卡格勒与普拉苏格勒对微循环阻力指数 (IMR) 和心脏病发作的影响.
主要方法:
- 一个随机试验,涉及110名接受初级PCI的STEMI患者.
- 患者接受了提卡格勒或普拉苏格勒的维持治疗.
- 使用微循环阻力指数 (IMR) 和心血管磁共振成像 (CMR) 在一个月后评估冠状动脉微血管损伤.
主要成果:
- 蒂卡格勒和普拉苏格勒组之间的IMR没有显著差异 (P=0. 08).
- 提卡与心内出血的发生率较低 (23%对43%,P=0. 04).
- 两组之间没有观察到心脏病大小或微血管阻塞的显著差异.
结论:
- 在预防STEMI患者的冠状动脉微血管损伤方面,蒂卡格勒维持疗法并不优于普拉苏格勒.
- 这两种药物在PCI后一个月产生了相似的心脏病发作大小和微血管阻塞.
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