学术研究联盟对东亚患者高出血风险定义的验证
Jinho Lee1, Min-Ju Kim2, Mijin Kim1
1Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
JACC. Asia
|June 16, 2023
概括
学术研究联盟-高出血风险 (ARC-HBR) 标准有效地识别了东亚急性冠状动脉综合征患者的出血和血栓事件风险较高. 这项验证支持在临床实践中对这些患者使用ARC-HBR标准.
科学领域:
- 心脏病学 心脏病学
- 临床药理学 临床药理学
- 翻译医学是一种翻译医学.
背景情况:
- 学术研究联盟高出血风险 (ARC-HBR) 标准在接受强抗血小板治疗的东亚急性冠状动脉综合征 (ACS) 患者的临床实用性尚不清楚.
- 准确识别患有高出血风险的患者对于优化抗血小板治疗策略在ACS管理中至关重要.
研究的目的:
- 验证ARC-HBR定义,用于确定东亚ACS患者的高出血风险,这些患者的目的是进行侵入性治疗.
- 评估ARC-HBR标准与该特定患者群体的出血和缺血结局之间的关联.
主要方法:
- 来自TICA KOREA试验的数据分析,该试验随机选择了800名韩国ACS患者接受蒂卡格洛尔或克洛皮多格雷尔.
- 患者被归类为高出血风险 (HBR),如果他们满足至少一个主要或两个小ARC-HBR标准.
- 主要终点包括血流学术研究联盟 (BARC) 3或5次出血和12个月的主要不良心血管事件 (MACE).
主要成果:
- 16.3%的患者被归类为HBR.
- 与非HBR患者相比,HBR患者的BARC 3或5出血率 (10.0%与3.7%) 和MACE (14.3%与6.1%) 显著更高.
- 提卡格雷勒与克洛皮多格雷尔对出血和缺血结局的相对治疗效果在HBR和非HBR组之间有所不同.
结论:
- 在韩国ACS患者中,ARC-HBR定义得到了验证,约有15%的患者被确定为HBR.
- 这些HBR患者面临出血和血栓事件的风险增加.
- 需要进一步的研究来探索ARC-HBR标准在指导抗血小板疗法选择的临床应用.
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