蒂卡格勒勒与克洛皮多格勒在克洛皮多格勒未使用的慢性冠状动脉综合征患者中的比较
Stéphane Manzo-Silberman1, Paul Guedeney1, Guillaume Cayla2
1Sorbonne Université, Allies in Cardiovascular Trials Initiatives and Organized Networks (ACTION) Study Group, INSERM UMRS1166, Hôpital Pitié-Salpêtrière (AP-HP), Paris, France.
蒂卡格勒勒在选择性皮肤冠状动脉干预 (PCI) 患者中没有减少周围手术性心肌缩. 前不服用克洛皮多格雷尔的患者的并发症较少,但这是由于风险概况较低,而不是使用的P2Y12抑制剂.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 药理学 药理学 是一个学科.
背景情况:
- 选择性穿皮冠状动脉干预 (PCI) 后的周围手术性心肌亡是一个令人担忧的问题.
- 提卡格雷勒与克洛皮多格雷尔在之前接受或没有接受克洛皮多格雷尔治疗的患者中的比较疗效尚不清楚.
研究的目的:
- 在接受选择性PCI的患者中比较蒂卡格罗和克洛皮多格雷尔.
- 评估之前的克洛皮多格雷尔治疗对结果的影响.
主要方法:
- 对ALPHEUS试验进行了预先规定的分析.
- 患者被分为从未服用克洛皮多格雷尔或接受过克洛皮多格雷尔治疗 (≥7天前).
- 主要终点:PCI相关的心肌梗塞和48小时内严重损伤的组合.
主要成果:
- 分析了1882名患者,42.7%接受了克洛皮多格雷尔治疗.
- 之前没有服用皮多格雷尔的患者的主要终点的发生率较低 (32.8%与40.0%相比).
- 与克洛皮多格雷尔相比,格雷勒没有减少周围手术心肌亡或不良结果,无论之前的治疗情况如何.
结论:
- 之前从未服用克洛皮多格雷尔的患者由于风险概况较低和PCI不那么复杂,经历了较少的外围手术并发症.
- 基线 klopidogrel 状态并没有改变 ticagrelor 和 klopidogrel 在 PCI 相关并发症方面的类似疗效.
- 克洛皮多格雷尔仍然是选择性PCI在患有或没有慢性克洛皮多格雷尔治疗的患者的标准护理.
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