通过皮肤冠状动脉干预后,在接受双抗血小板治疗的患者中,对肠道出血的预测工具的验证
Pedro Cortés1, Jennifer J Zeng2, Christian Karime1
1Division of Internal Medicine, Mayo Clinic, Jacksonville, Florida, USA.
Gastrointestinal endoscopy
|August 14, 2023
概括
通过皮肤冠状动脉干预 (PCI) 后预测胃肠道出血 (GIB) 是至关重要的. 一个新的SIGE评分有效预测复发性出血,这增加了主要不良心血管事件 (MACE) 的风险.
科学领域:
- 心脏病学 心脏病学
- 胃肠病学 胃肠病学
- 临床药理学 临床药理学
背景情况:
- 通过皮肤冠状动脉干预 (PCI) 和胃肠道出血 (GIB) 后的双重抗血小板治疗管理是一个临床挑战.
- 识别GIB和复发出血的预测因素对于患者管理至关重要.
- 了解复发性出血与重大心血管不良事件 (MACE) 之间的联系至关重要.
研究的目的:
- 在接受PCI的患者中确定GIB和复发性出血的预测因素.
- 为了确定复发性出血是否会增加MACEs的风险.
- 开发一种新的风险评分,用于预测复发性出血.
主要方法:
- 这是一项单一中心的回顾性研究,对536名接受PCI的患者进行.
- 后勤回归用于识别GIB和复发出血的预测因素.
- 考克斯的比例危险建模,以评估MACE复发性出血的预测值.
- 开发和验证用于预测复发性出血的SIGE得分.
主要成果:
- 对于急性冠状动脉综合征的PCI与GIB的几率增加95%有关.
- 该HAS-BLED得分,包括不稳定的INR和先前的大型出血,强烈预测了复发出血.
- 复发性出血与115%的MACE风险增加有关.
- 新的SIGE得分显示了对复发出血的高预测准确性 (AUC,0.773).
结论:
- 在PCI后,SIGE评分在预测复发性出血方面表现有前途.
- 复发性出血是MACEs的一个重要风险因素.
- 建议对SIGE评分进行进一步的外部验证.
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