低剂量prasugrel对接受皮肤冠状动脉干预的老年患者的抗血小板作用
Monica Verdoia1, Matteo Nardin2, Rocco Gioscia1
1Division of Cardiology, Ospedale Degli Infermi, ASL Biella, Italy.
Current vascular pharmacology
|June 7, 2024
概括
在经皮冠状动脉干预后接受低剂量普拉苏格勒治疗的老年患者中,高治疗剩余血小板反应率 (HRPR) 是常见的. 增加的体重指数 (BMI) 是这个人群中HRPR的主要预测因素.
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.
- 血栓形成的原因之一是血栓形成.
背景情况:
- 低剂量普拉苏格勒 (5毫克) 适用于晚年或体重低的急性冠状动脉综合征 (ACS) 患者.
- 在这个高风险群体中常规使用剂量调整后的普拉苏格勒仍然是有争议的.
研究的目的:
- 在接受低剂量普拉苏格勒 (5毫克) 的老年患者中,确定高治疗残留血小板反应率 (HRPR) 的患病率和预测因素.
- 为了评估常规剂量调整的普拉苏格勒对这个患者子组的适当性.
主要方法:
- 一项涉及59名老年患者 (≥75岁) 的研究,他们接受了双抗血小板治疗 (DAPT) 与阿司匹林和普拉苏格雷尔 (5毫克) 后皮肤冠状动脉干预 (PCI).
- 血小板功能被评估30-90天后,使用全血阻抗聚合计.
主要成果:
- 在42.4%的患者 (25/59) 中观察到HRPR,随访时间中位数为43天.
- 较高的体重指数 (BMI),较低的维生素D水平和酸盐使用与HRPR有关.
- 多变量分析发现BMI是普拉苏格勒HRPR的唯一独立预测因子,BMI>26是最佳切线 (aOR=8.6,p=0.002).
结论:
- 在接受PCI后的DAPT治疗的老年患者中,当他们接受低剂量普拉苏格雷尔治疗时,HRPR很普遍.
- 增加的BMI (≥26) 是HRPR的唯一独立预测因子,在这个人群中使用5毫克普拉苏格勒是唯一的独立预测因子.
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