在双重抗血小板治疗期间急性冠状动脉综合征后缺血和出血事件风险的时间变化
Toshiharu Fujii1, Satoshi Kasai2, Yota Kawamura2
1Division of Cardiology, Tokai University School of Medicine, Isehara, Japan; Division of Cardiology, Tokai University Hachioji Hospital, Hachioji, Japan.
International journal of cardiology
|September 7, 2023
概括
60天的双重抗血小板治疗 (DAPT) 持续时间平衡了急性冠状动脉综合征 (ACS) 后的缺血和出血风险. 这种持续时间是有效的,无论患者的高出血风险 (HBR) 状态.
科学领域:
- 心脏病学 心脏病学
- 临床研究 临床研究
- 药理学 药理学是指药理学的学科.
背景情况:
- 双抗血小板治疗 (DAPT) 在急性冠状动脉综合征 (ACS) 后至关重要.
- 使用高出血风险学术研究联盟 (ARC-HBR) 标准进行患者分层是必不可少的.
- 了解DAPT期间缺血和出血事件的时间风险变化至关重要.
研究的目的:
- 估计DAPT期间缺血和出血事件的时间风险变化.
- 根据ARC-HBR标准对患者进行分层.
- 为了确定ACS.之后的最佳DAPT持续时间.
主要方法:
- 1264名接受阿司匹林加上克洛皮多格雷尔或普拉苏格雷尔的ACS患者被ARC-HBR分类.
- 多中心观测研究设计.
- 考克斯危险和罗伊斯顿-帕马尔模型用于估计时间风险变化.
主要成果:
- 在313天内,缺血事件发生在9.4%,出血事件发生在7.4%.
- 高出血风险 (HBR) 患者的缺血 (15.3%) 和出血 (11.9%) 事件的发生率显着更高.
- 缺血事件的风险超过了HBR和非HBR组的60天内出血事件的风险.
结论:
- 60天的DAPT有效平衡了ACS后的缺血和出血事件风险.
- 这种DAPT持续时间是适当的,不管患者的ARC-HBR分类.
- 这些发现支持为ACS患者提供标准化的60天DAPT治疗方案.
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