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在接受复杂的皮肤冠状动脉干预的患者中,治疗期间血小板活性较高
Lukáš Urban1,2, Škorňová Ingrid3, Jana Žolková3
1Department of Internal Medicine I., Jessenius Faculty of Medicine, Comenius University, University Hospital Martin, Martin, Slovakia.
复杂的PCI后高的治疗前血小板反应率 (HTPR) 会增加血栓形成的风险. HTPR测试可以帮助识别高风险患者,指导P2Y12抑制剂的选择,以预防并发症.
科学领域:
- 心脏病学 心脏病学
- 药理学 药理学是指药理学的学科.
- 血液学 血液学 血液学
背景情况:
- 患者对P2Y12抑制剂的反应是可变的.
- 治疗时高血小板反应率 (HTPR) 与血栓形成风险增加相关.
- 复杂的皮肤穿冠状动脉干预 (PCI) 患者是高危人群.
研究的目的:
- 评估HTPR测试在复杂PCI后高风险患者的临床益处.
- 评估HTPR患病率及其与血栓性并发症的关联.
主要方法:
- 复杂PCI后1天和1个月收集的血液样本.
- 使用血管扩散剂刺激的蛋白酸化 (VASP-P) 和血小板功能测定 (PFA) 评估HTPR.
- 在1年内监测了支架血栓形成和目标血管再血管化.
主要成果:
- HTPR流行:VASP-P (37%在1天,30.9%在1个月);PFA (33.3%在1天,19.8%在1个月).
- 在接受克洛皮多格雷尔治疗的患者中观察到更高的HTPR,而不是提卡格雷尔和普拉苏格雷尔.
- 发生了三例支架血栓形成 (2例早期,1例晚期).
结论:
- 在复杂的PCI后的患者中,HTPR普遍存在.
- 检测HTPR可能有助于预防血栓事件.
- 在复杂的PCI中对P2Y12抑制剂反应的进一步研究是有必要的.
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