在缺血性中风中多重抗血小板治疗已经在抗血小板剂上,基于中风的链接大数据
Tae Jung Kim1,2, Ji Sung Lee3, Jae Sun Yoon1
1Department of Neurology, Seoul National University Hospital, Seoul, Korea.
Journal of Korean medical science
|September 26, 2023
概括
在非心血管血栓性中风的单次抗血小板治疗 (SAPT) 中增加更多的抗血小板治疗并没有降低血管风险. 然而,三重抗血小板治疗显著增加了已经在SAPT的患者的主要出血并发症.
科学领域:
- 神经学 神经学
- 心脏病学 心脏病学
- 药理学 药理学是指药理学的学科.
背景情况:
- 单次抗血小板治疗 (SAPT) 的缺血性中风患者的最佳抗血小板策略尚不清楚.
- 这项研究评估了先前接受SAPT的非心血管血栓性中风患者的抗血小板治疗方案.
研究的目的:
- 评估双抗血小板治疗 (DAPT) 和三重抗血小板治疗 (TAPT) 与持续的SAPT对血管和安全结果在一年后的影响.
- 确定强化抗血小板治疗是否能改善已经接受SAPT的患者在非心血管血栓性中风后的结果.
主要方法:
- 在SAPT上对9,284名急性非心血管血栓性缺血性中风患者进行了回顾性分析.
- 患者根据出院药物分为SAPT,DAPT或TAPT组进行分层.
- 一年后的结果包括复发性缺血性中风,血管事件和死亡的组合,以及严重出血.
主要成果:
- 多重抗血小板治疗 (DAPT/TAPT) 并没有显著降低复发性缺血性中风或一年后综合结局的风险.
- 三重抗血小板治疗 (TAPT) 与严重出血并发症 (HR 4.65) 的风险显著增加有关.
- 双重抗血小板治疗 (DAPT) 显示出非显著的趋势,导致出血风险增加 (HR 1.23).
结论:
- 除了SAPT外,加强抗血小板治疗并不能改善非心血管血栓性中风患者1年的血管结果.
- 三重抗血小板疗法显著提高了主要出血并发症的风险在这个患者群体.
- 这些发现表明,持续的SAPT可能是对特定患者的更安全的策略.
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