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在心肌梗塞患有高出血风险的心肌梗塞患者中,提卡格雷勒和克洛皮多格雷尔之间的比较
Jonathan Tjerkaski1, Tomas Jernberg1, Joakim Alfredsson2
1Department of Clinical Sciences, Danderyd University Hospital, Karolinska Institute, Stockholm, 18257 Danderyd, Sweden.
概括
在高出血风险的心肌梗塞患者中,蒂卡格勒罗比克洛皮多格雷尔显示出较低的缺血事件,但出血风险较高. 两种疗法之间没有观察到净不良临床事件的显著差异.
科学领域:
- 心血管医学 心血管医学
- 药理学 药理学是指药理学的学科.
- 临床研究 临床研究
背景情况:
- 与克洛皮多格雷尔相比,蒂卡格雷勒提供了优越的缺血事件减少.
- 在高出血风险 (HBR) 患者中,强化抗胰岛症治疗与重大出血风险的益处风险平衡尚不清楚.
研究的目的:
- 在心肌梗塞 (MI) 患有高出血风险 (HBR) 的患者中,比较提卡格雷勒与克洛皮多格雷尔的疗效和安全性.
- 为了评估接受蒂卡格雷勒或克洛皮多格雷尔的HBR患者的缺血事件,出血事件和死亡率.
主要方法:
- 从SWEDEHEART注册表 (2010-2017年) 追溯分析了25 042名在双抗血小板治疗中出院的HBR患者.
- 高出血风险是通过PRECISE-DAPT评分≥25.5来定义的.
- 结果包括365天内的缺血事件 (心脏病发作,中风),主要出血,死亡率,主要不良心血管事件 (MACE) 和净不良临床事件 (NACE).
主要成果:
- 与克洛皮多格雷尔相比,提卡格雷勒的使用与心脏病发作,中风和MACE的减少有关.
- 提卡格还与严重出血的风险增加有关.
- 在两个治疗组之间,没有发现死亡率或NACE的显著差异.
结论:
- 在HBR MI患者中,蒂卡格勒罗和克洛皮多格勒在净不良临床事件 (NACE) 中没有显著差异.
- 在更广泛的MI人群中,没有观察到出血风险 (PRECISE-DAPT得分) 和提卡格勒罗和克洛皮多格雷尔的比较有效性之间的统计学上显著的相互作用.
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