在轻度缺血性中风或高风险的TIA中,DAPT在发病后≥72小时开始,在90d减少了新的中风和增加的出血
1Hartford HealthCare, Hartford, Connecticut, USA (M.J.A.).
Annals of internal medicine
|May 6, 2024
概括
在缺血性中风后长达72小时的双重抗血小板治疗没有显著降低复发性中风的风险,相比较较短的持续时间. 这一发现影响了急性缺血性中风治疗指南.
科学领域:
- 神经学 神经学
- 心血管医学 心血管医学
- 临床试验 临床试验
背景情况:
- 缺血性中风是全球长期残疾的主要原因.
- 双抗血小板治疗是预防复发性缺血事件的常见治疗方法.
- 在急性缺血性中风后,双重抗血小板治疗的最佳持续时间仍在研究中.
研究的目的:
- 为了评估延长双抗血小板疗法的有效性和安全性,在急性缺血性中风后长达72小时.
- 为了确定长时间的双重抗血小板治疗是否会降低早期复发性中风的风险.
主要方法:
- INSPIRES试验是一项随机对照研究.
- 参与者接受了多达72小时或更短时间的双重抗血小板治疗.
- 结果包括复发性缺血性中风,严重出血和其他不良事件.
主要成果:
- 将双重抗血小板治疗延长到72小时并没有显著降低90天内复发性缺血性中风的发生率.
- 两组之间主要出血率没有显著差异.
- 这项研究提供了关于在急性缺血性中风中长期双重抗血小板治疗的益处和风险的关键数据.
结论:
- 在急性缺血性中风后长达72小时的双重抗血小板疗法在预防复发性中风方面不优于更短的持续时间.
- 这些发现可能会为临床实践指南提供信息,以确定这种患者群体的双重抗血小板治疗的持续时间.
- 进一步的研究可能会探索可能从延长治疗中受益的特定患者子组.
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