对心血管疾病患者抗血栓治疗强化试验的概括性
Maria C Castelijns1, Steven H J Hageman1, Martin Teraa2
1Department of Vascular Medicine, University Medical Center Utrecht, Utrecht, The Netherlands.
Heart (British Cardiac Society)
|January 5, 2024
概括
许多患有心血管疾病 (CVD) 的患者有资格参加强化抗血栓治疗试验. 这些患者的调整事件风险在很大程度上反映了那些不符合条件的患者,这表明指南建议适用.
科学领域:
- 心血管医学 心血管医学
- 临床试验 临床试验
- 药理学 药理学是指药理学的学科.
背景情况:
- 在心血管疾病 (CVD) 中强化抗血栓治疗的指导建议通常基于临床试验.
- 这些试验结果对真实世界患者群体的概括性仍然是临床实践的关键考虑因素.
研究的目的:
- 评估冠状动脉疾病 (CAD) 和/或外周动脉疾病 (PAD) 患者对主要抗血栓治疗试验的现实适用性.
- 为了在现实世界队列中比较符合条件和不符合条件的患者之间的基线特征,心血管事件,出血风险和死亡率.
主要方法:
- 从关键试验 (COMPASS,CHARISMA,PEGASUS-TIMI,DAPT) 中的纳入和排除标准应用于乌得勒支心血管队列第二次动脉疾病表现 (UCC-SMART) 研究中的患者.
- 确定了强化抗血栓治疗的现实世界资格.
- 在符合条件和不符合条件的患者组之间进行了结果的统计比较.
主要成果:
- 在实践中,在不同试验中,符合条件的患者在实践中差异很大,在CAD患者中从11%到94%,在PAD患者中从75%到90%.
- 与不符合条件的患者相比,符合COMPASS资格的CAD患者心血管事件,出血和死亡风险更高.
- 在调整后,符合COMPASS资格的CAD患者仍然存在较高的心血管和死亡风险,而符合CHARISMA和DAPT资格的CAD患者的心血管风险较低.
结论:
- 相当一部分患有心血管疾病的当代患者符合强化抗血栓治疗试验的资格标准.
- 符合条件的现实世界患者的调整后事件风险大多与不符合条件的患者的风险相似.
- 基于试验的抗血栓治疗指南建议似乎在很大程度上适用于更广泛的心血管疾病患者群体.
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