通过皮肤进行冠状动脉干预后使用阿司匹林与克洛皮多格勒进行长期维持单一治疗:HOST-EXAM扩展研究
Jeehoon Kang1, Kyung Woo Park1, Huijin Lee1
1Seoul National University Hospital, Korea (J.K., K.W.P., H.L., D.H., H.-M.Y., J.-K.H., B.-K.K., H.-S.K.).
Circulation
|November 7, 2022
概括
与阿司匹林相比,通过皮肤输出支架进行冠状动脉干预后长期单一治疗可显著减少主要不良事件. 这项扩大后续调查证实了克洛皮多格勒的
科学领域:
- 心脏病学
- 药理学
- 临床试验
背景情况:
- 使用药物释放支架 (DES) 进行皮肤冠状动脉干预 (PCI) 后的抗血小板单一治疗的长期结果尚不完全理解.
- 这项HOST- EXAM扩展研究提供了对抗血小板单一治疗策略的关键后续数据.
研究的目的:
- 评估克洛皮多格勒单疗与阿司匹林单疗的长期疗效和安全性.
- 在克洛皮多格勒和阿司匹林单一治疗组之间比较综合净临床结果,血栓事件和出血事件.
主要方法:
- 在12±6个月的双重抗血小板治疗中,有5348名DES- PCI患者被随机分配到克洛皮多格勒或阿司匹林单一治疗中.
- 主要终点:死亡,心肌梗塞,中风,ACS再入院和BARC≥3出血的综合结果.
- 二次终点:在延长的随访期内分析的血栓和出血事件.
主要成果:
- 在中位数为5. 8年的时间里,克洛皮多格雷尔单独治疗的初级复合终点率显著降低 (12. 8% vs 16. 9%;HR 0. 74,P< 0. 001).
- 用克洛皮多格雷尔观察到二次血栓形成的风险降低 (HR 0.66,P< 0.001) 和出血的终点 (HR 0.74,P=0.016).
- 两组之间无显著的死亡率差异 (P=0. 742);克洛皮多格勒的长期益处是一致的.
结论:
- 与阿司匹林单一治疗相比,克洛皮多格雷尔单一治疗在特定的PCI患者中具有更好的长期临床结果.
- 这些发现支持单独使用克洛皮多格勒作为一种潜在的更有效的策略来减少缺血事件,同时管理PCI后的出血风险.
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