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抗血栓管理:使用VerifyNow测试对血小板活性导向的康格勒尔剂量的评估
Alexander Connery1, Tania Ahuja1,2, Alyson Katz1
1Department of Pharmacy, NYU Langone Health, New York, NY.
Journal of cardiovascular pharmacology
|February 9, 2024
概括
一个标准化的格罗尔剂量协议成功地实现了重症患者的P2Y12血小板反应单位 (PRU) 目标,包括那些有机械循环支持 (MCS) 患者. 这种方法有助于管理格罗尔疗法,尽管最佳的PRU水平需要进一步研究.
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.
- 临界护理医学 临界护理医学
背景情况:
- 康格洛尔在暂时的双重抗血小板治疗中断期间作为桥梁治疗.
- 最佳的剂量和监测,特别是机械循环支持 (MCS),仍然不清楚.
研究的目的:
- 为了评估标准化 cangrelor 剂量协议在重症患者的有效性.
- 评估与康格勒罗使用相关的主要不良心血管事件,血小板反应性和出血事件.
主要方法:
- 追溯观察队列研究92重症监护病房患者接受康格勒或皮肤穿刺后冠状动脉干预.
- 主要结局:主要的心血管不良事件. 二次结果:P2Y12反应单位 (PRU) 和出血事件.
主要成果:
- 观察到较低的重大心血管不良事件发生率 (1.1%).
- 89%的患者实现了<194的P2Y12 PRU目标,中位数为115个PRU.
- 出血事件的发生率为23%.
结论:
- 一个标准化的格罗尔剂量方案有效地实现了重症患者的目标P2Y12 PRU,包括患有MCS的患者.
- 监测PRU可以指导毛虫的管理,但需要进一步的试验来确定最佳值,以平衡缺血和出血风险.
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