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在三药的发起者中发生中风和心肌梗塞的风险
Christian Lund Petersen1,2, Anders Hougaard3,4, David Gaist5
1Department of Clinical Pharmacology, Odense University Hospital, Odense, Denmark.
JAMA neurology
|February 5, 2024
概括
使用三可能会增加缺血性中风和心肌梗塞的风险,特别是在高风险患者中. 然而,对于心血管风险较低的人来说,绝对风险仍然非常低.
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:
- 在患有缺血性心脏病的患者中,由于潜在的心血管风险,三药通常是禁忌的.
- 之前的观察性研究已经产生了矛盾的结果,关于triptan使用和缺血事件之间的关联.
- 避免在患有心血管风险因素的患者中接受普坦治疗的临床意义尚不清楚.
研究的目的:
- 通过使用强大的自我控制研究设计,研究三开始和缺血事件之间的关联.
- 为了减轻传统观测研究中固有的混因素.
主要方法:
- 从1995年1月到2022年8月,使用丹麦登记处进行了一项全国性的案例交叉研究.
- 确定了启动三剂并经历缺血后果 (心肌梗塞,缺血性中风) 的个人.
- 在事件发生前的2周内,与4个2周的参考期进行了比较.
主要成果:
- 这项研究包括429612名开始服用三药的人.
- 开始服用普坦与心肌梗塞 (OR,3.3) 和缺血性中风 (OR,3.2) 的风险增加有关.
- 经历事件的患者年龄较大,心血管风险概况较高.
结论:
- 开始服用普坦似乎与缺血性中风和心肌梗塞的风险增加有关.
- 在开始服用平药后发生缺血事件的绝对风险对于基线心血管风险较低的人来说非常低.
- 这些发现强调了在开处方三药时个性化风险评估的重要性.
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