缺血性中风患者的高强度与中等强度他类药物治疗:全国性队列研究
Frederikke Bach1, Nils Skajaa1, Buket Öztürk Esen1
1Department of Clinical Epidemiology, Department of Clinical Medicine, Aarhus University & Aarhus University Hospital, Aarhus, Denmark.
缺血性中风后的高强度他类药物与中等强度他类药物相比,显示出类似的有效性和安全性. 然而,高强度他类药物的使用与降低死亡率,但增加患糖尿病的风险有关.
科学领域:
- 心血管医学 心血管医学
- 神经学 神经学
- 药理学 药理学是指药理学的学科.
背景情况:
- 目前的指导方针主张在缺血性中风后进行高强度的他类药物治疗.
- 在这个患者群体中比较不同强度的他类药物的有效性和安全性的证据是有限的.
研究的目的:
- 为了评估高强度与中等强度他类药物在缺血性中风后患者中启动高强度的有效性和安全性.
主要方法:
- 一项以人口为基础的队列研究利用丹麦的登记册来识别病类药物的新用户后缺血性中风 (2012-2021年).
- 倾向性评分权衡和竞争风险方法被用来比较高强度和中等强度他类药物发起者的结果.
- 疗效结局包括中风复发,心肌梗塞,心力衰竭,静脉血栓栓塞和全因死亡率.
- 安全结果包括糖尿病,肝病和病的发病率.
主要成果:
- 在高强度和中等强度的他类药物组之间,对于大多数有效性和安全性结果的风险没有明显的差异.
- 在高强度他类药物开始时,所有原因死亡率略有降低 (HR:0.93).
- 患糖尿病的风险增加与高强度他类药物使用有关 (HR:1.10).
结论:
- 在缺血性中风后开始使用高强度他类药物,对于大多数结果,其有效性和安全性与中等强度他类药物相似.
- 高强度的他类药物治疗可能会带来死亡率的好处,但会带来新发糖尿病的风险略高.
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