复杂的皮肤冠状动脉干预后双重抗血小板治疗的短期持续时间:系统性审查和元分析
Mohamed Magdi Eid1, Mostafa Reda Mostafa1, Ahmad Alabdouh2
1Rochester Regional Health/Unity Hospital, Rochester, NY, USA.
概括
复杂的皮肤冠状动脉干预 (PCI) 后1-3个月的较短的双重抗血小板治疗 (DAPT) 可能会减少严重出血. 这一持续时间显示,与12个月的DAPT相比,心血管事件的发生率相似.
科学领域:
- 心血管医学 心血管医学
- 干预心脏病学 干预心脏病学
- 药理学 药理学是指药理学的学科.
背景情况:
- 复杂皮肤冠状动脉干预 (PCI) 后的双重抗血小板治疗 (DAPT) 的最佳持续时间尚未确定.
- 在患者管理中,平衡DAPT的益处与出血风险至关重要.
研究的目的:
- 在接受复杂PCI的患者中,比较1-3个月的DAPT后单一治疗和12个月的DAPT的疗效和安全性.
- 评估DAPT持续时间对主要出血和关键心血管结果的影响.
主要方法:
- 进行了随机对照试验的元分析.
- 搜索的数据库包括 MEDLINE/PubMed,EMBASE 和 Cochrane 中央对照试验登记册,截至 2023 年 1 月.
- 评估的关键结局是主要出血,全因死亡率,心血管死亡率,心肌梗塞,支架血栓,目标血管再血管化和中风.
主要成果:
- 与12个月 (OR 0.67;95% CI,0.44-1.00;p=0.05) 相比,在1至3个月的DAPT中观察到较少严重出血的趋势.
- 在所有原因死亡率,心血管死亡率,心肌梗塞,支架血栓形成,目标血管再血管化或中风方面,在较短和较长的DAPT持续时间之间没有发现显著差异.
结论:
- 1-3个月的双重抗血小板治疗可能是复杂PCI患者的可行选择,可能降低出血风险.
- 与标准的12个月疗程相比,较短的DAPT持续时间似乎保持了与主要不良心血管事件相似的保护.
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