冠状动脉旁路移植后不同的抗血栓策略,以预防不良事件:回顾性分析
Yi Shi1, Shenglong Chen1, Gang Liu1
1Department of Cardiac Surgery, Peking University People's Hospital, Peking University Health and Science Center, Xizhimen St, Beijing, 100044, China.
Journal of cardiothoracic surgery
|July 4, 2024
概括
在冠状动脉旁路移植 (CABG) 后的早期双重抗血小板治疗 (DAPT) 是安全的,没有增加出血风险. 然而,将抗凝剂与抗血小板治疗结合起来,会引起CABG患者出血的担忧.
科学领域:
- 心脏病学 心脏病学
- 心血管外科心血管外科
- 药理学 药理学是指药理学的学科.
背景情况:
- 冠状动脉旁路移植 (CABG) 经常涉及抗血栓治疗.
- 在CABG后早期使用抗血栓剂的安全性和有效性仍在调查中.
研究的目的:
- 评估术后抗血栓策略与住院不良事件之间的关联.
- 在接受单独CABG的患者中比较出血和不良事件风险.
主要方法:
- 对3274名接受隔离CABG (2001-2012) 的患者进行了回顾性队列分析.
- 患者被分组为单抗阿司匹林 (ASA) 或双抗血小板治疗 (DAPT:阿司匹林加克洛皮多格雷尔).
- 倾向分数匹配 (PSM) 用于控制混因素.
主要成果:
- 在PSM后的ASA和DAPT组之间没有观察到重大出血风险的显著差异.
- 术后死亡率在两组之间没有差异.
- 抗凝药疗法,特别是早期的肝素使用,独立预测出血相关事件的增加.
结论:
- 双抗血小板治疗 (DAPT) 是CABG后的安全抗血小板策略,与增加的出血无关.
- 同时使用抗凝剂和抗血小板治疗会增加出血风险,需要谨慎的临床应用.
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