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比瓦利鲁丁与肝素在ST和非ST段升高心肌梗塞-两年后的结果

Elmir Omerovic¹, Stefan James², Truls Råmundal¹

¹Dept of Cardiology, Sahlgrenska University, Gothenburg, Sweden.

Cardiovascular revascularization medicine : including molecular interventions

|April 4, 2024

概括

在VALIDATE-SWEDEHEART试验的两年随访中,对于因心肌梗塞 (MI) 接受皮肤冠状动脉干预 (PCI) 的患者,比瓦利鲁丁和肝素之间的结果没有差异. 这些发现支持在心脏病发作患者中继续使用这两种抗凝剂.

科学领域:

心脏病学心脏病学
干预心脏病学干预心脏病学
临床试验临床试验

背景情况:

在VALIDATE-SWEDEHEART试验中,研究了经皮冠状动脉干预 (PCI) 的心肌梗塞 (MI) 患者的抗凝策略.
一年后的初步结果显示,在比瓦利鲁丁和肝素之间的初级复合终点中没有显著差异.
这项分析将后续行动延长到两年,以评估长期结果.

研究的目的:

为了比较比瓦利鲁丁与肝素的疗效和安全性,在接受PCI至多两年的MI患者中.
评估不同抗凝剂对主要心血管不良事件和出血的长期影响.

主要方法:

一个基于注册的随机试验,涉及6006名ST段升高MI (STEMI) 和非STEMI (NSTEMI) 的患者.
在PCI期间,患者被分配接受白鲁丁或肝素.
在两年后的随访中,按照研究方案中预先规定的初级和二级终点进行了分析.

主要成果:

主要终点 (死亡,心脏病发作或严重出血的综合结果) 在两年内发生在比瓦利鲁丁组的16.7%人群中,而在肝素组的17.1%人群中 (HR 0.97;95% CI,0.96-1.10;P=0.66).
对于一年或两年后的初级终点,两组治疗组之间没有发现显著差异.
结果在包括STEMI和NSTEMI患者在内的子组中一致.

结论:

延长两年的随访证实,在接受PCI的MI患者中,比瓦利鲁丁和肝素之间的主要临床终点没有显著差异.
这两种抗凝剂在这个患者群体中表现出相似的安全性和有效性.
这些发现为急性冠状动脉综合征的抗凝管理提供了有价值的长期数据.

关键词:

比瓦利鲁丁 (Bivalirudin) 是一种可以心肌梗塞的心脏病发作这是PCI的PCI.没有分离的肝素.

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