确定风险最高的血管患者:来自XATOA注册表的见解
Sonia S Anand1, Victor Aboyans2, Jackie Bosch3
1Population Health Research Institute, Hamilton, Ontario, Canada; Department of Medicine, McMaster University, Hamilton, Ontario, Canada.
服用低剂量里瓦洛克萨班和阿司匹林的多血管疾病患者面临心血管和四肢事件的最高风险. 识别这些高风险个体对于优化治疗策略和预防不良结果至关重要.
科学领域:
- 心血管医学 心血管医学
- 血管外科 血管外科
- 药理学 药理学是指药理学的学科.
背景情况:
- 患有冠状动脉疾病 (CAD) 和外周动脉疾病 (PAD) 的患者经常经历主要心血管和四肢不良事件的残留风险.
- 当前的护理标准可能无法在所有患者群体中完全减轻这些风险.
研究的目的:
- 为了确定患有CAD和/或PAD接受低剂量里瓦洛克萨班 (2.5毫克两次) 和阿司匹林的患者中风险最高的患者子组.
- 分析动脉样硬化患者的治疗模式和结果.
主要方法:
- 沙雷托加乙酸:动脉样硬化患者的治疗模式和结果 (XATOA) 登记册注册了5532名接受低剂量里瓦洛克萨班和阿司匹林的患者.
- 使用分类和回归树分析来确定独立的高风险子组.
- 报告了主要不良心血管事件 (MACE),主要不良四肢事件 (MALE) 和重大出血的发生风险.
主要成果:
- 多血管疾病 (影响≥2个血管床) 与非多血管患者 (≥2个血管床) 相比,MACE或MALE的发病率风险最高 (每100个患者年9.16),与非多血管患者 (每100个患者年2.48) 相比.
- 其他高风险因素包括75岁以上的年龄,糖尿病史,心力衰竭或慢性功能不足 (CRI).
- 分类和回归树分析确定多血管疾病是主要的风险因素,由CRI或糖尿病进一步放大.
结论:
- 患有多血管疾病的患者构成一个重要的临床人群,需要优先治疗.
- 对于这些高风险患者,应考虑最大限度的医疗治疗,包括低剂量里瓦洛克萨班 (2.5毫克两次) 和阿司匹林.
- 这项研究强调了在患有动脉样硬化的患者中识别和管理多血管疾病的重要性.
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