在经皮冠状动脉干预后停止与呼吸不良相关的提卡格勒勒
Dominick J Angiolillo1, Davide Cao2, Samantha Sartori3
1Division of Cardiology, University of Florida College of Medicine, Jacksonville, Florida, USA.
JACC. Cardiovascular interventions
|October 25, 2023
概括
呼吸障碍是蒂卡格勒罗尔的常见副作用,导致许多患者在经过皮肤冠状动脉干预 (PCI) 后停止治疗. 识别这种副作用的预测因素可以帮助管理治疗坚持.
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.
- 临床试验 临床试验
背景情况:
- 呼吸障碍影响了近20%的患者服用提卡格.
- 这种副作用可能导致高达三分之一的受影响患者停止治疗.
研究的目的:
- 评估与呼吸障碍相关的提卡格勒或停止治疗的发生率,预测因素和结果.
- 为了分析来自TWILIGHT试验的数据.
主要方法:
- 利用TWILIGHT试验的数据,随机分配患者在初始治疗后接受提卡格勒罗加阿司匹林或单独服用提卡格勒罗.
- 在PCI后3个月进行了基准分析.
- 采用多变量考克斯回归来识别呼吸障碍相关停药的预测因素.
主要成果:
- 与呼吸障碍相关的提卡格雷勒停药的发生率在PCI后3个月为6.4%,在PCI后15个月为9.1%.
- 预测因素包括亚洲种族 (风险较低),吸烟,先前的PCI,高胆固醇血症,先前的冠状动脉旁路术,外周动脉疾病,肥胖和年龄较大.
- 与继续双重治疗相比,由于呼吸障碍而停止提卡格雷勒的治疗并没有增加随后缺血事件的风险.
结论:
- 与呼吸不良相关的提卡格雷勒停药影响了近10%的患者,通常发生在PCI后的早期.
- 识别人口和临床预测因素有助于管理患有不服药风险的患者.
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