脑卒中和过渡性缺血性发作 在每年双重抗血小板治疗期间发生
Victor L Serebruany1, Jean-Francois Tanguay2, Milana L Gurvich3
1Department of Neurology, Johns Hopkins University, Baltimore, MD.
American journal of therapeutics
|September 15, 2023
概括
大多数急性冠状动脉综合征后的中风和TIA发生在双抗血小板治疗的第一天内. 这表明更短的治疗时间可能是预防中风的安全和有效方法.
科学领域:
- 心脏病学 心脏病学
- 神经学 神经学
- 临床试验 临床试验
背景情况:
- 在急性冠状动脉综合征 (ACS) 的年度双抗血小板治疗 (ADAPT) 期间,中风/TIA的高发病率.
- 需要确定ADAPT的最佳持续时间,以充分保护血管并降低脑血管事件风险.
- 在ADAPT期间发生中风/TIA的时间不清楚.
研究的目的:
- 准确确定ADAPT期间在ACS患者中发生的二次脑血管事件的时间.
主要方法:
- 从血小板抑制和结果 (PLATO) 试验 (PLATO) 的数据进行了后期分析.
- 在服用阿司匹林后探索中风/TIA时间.
- 在ACS之后的365天内,事件被计算和绘制出来.
主要成果:
- 从18624名入学者中分析了238次中风和45次TIA.
- 最常见的中风/TIA发生在ACS后的第一天内.
- 事件发生率在第7天和第40天后下降,随后达到背景水平.
- 提卡格雷勒手臂在第一天出现事件的数量增加了两倍,并且出现过多的晚期排除.
结论:
- 大多数脑血管事件发生在ACS后的早期,即使在ADAPT.
- 这些发现支持探索比ADAPT更短的持续时间来预防中风后的ACS.
- 早期的事件和晚期的提卡格勒勒排除需要进一步调查.
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