冠状动脉旁路移植中的抗血小板抵抗:系统性审查
Myat Soe Thet1, Amir Khosravi2, Samson Egbulonu3
1Department of Surgery and Cancer, Imperial College London, London, UK.
Surgery research and practice
|June 24, 2024
概括
这次审查发现冠状动脉旁路移植患者中阿司匹林和克洛皮多格雷尔耐药性的显著率. 尤其是克洛皮多格雷尔耐药性,与更糟糕的临床结果和增加的移植闭塞风险有关.
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.
- 血管外科 血管外科
背景情况:
- 对阿司匹林和克洛皮多格雷尔的耐药性是冠状动脉旁路移植 (CABG) 患者的担忧.
- 了解抗血小板耐药性对于优化CABG患者的治疗结果至关重要.
研究的目的:
- 系统地审查阿司匹林和克洛皮多格雷尔耐药性在CABG患者的发生和影响.
- 检查用于评估抗血小板耐药性的方法.
主要方法:
- 在主要数据库 (PubMed,MEDLINE,Embase,Cochrane CENTRAL) 进行了广泛的文献搜索,直到2024年5月.
- 包括19项高质量的研究 (4项RCT,15项观察性) 涉及3,915名患者.
主要成果:
- 抗阿司匹林的发病率从11.0%到51.5%不等;克洛皮多格雷尔的耐药性为22%.
- 通过各种方法评估的抗血小板抵抗与静脉移植封闭风险增加13倍相关.
- 克洛皮多格雷尔耐药性与较高的死亡率,心肌梗塞和目标血管再血管化有关.
结论:
- 缺乏对抗血小板耐药性的标准化定义和可互换的评估方法.
- 虽然阿司匹林耐药性的影响是相互矛盾的,但克洛皮多格雷尔耐药性显然与CABG患者的不良临床结果有关.
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