质子抑制剂对接受皮肤冠状动脉干预的高危子组患者的长期影响
Ko Yamamoto1, Erika Yamamoto2, Takeshi Morimoto3
1Department of Cardiology, Kokura Memorial Hospital.
概括
质子抑制剂 (PPI) 降低了经皮冠状动脉干预 (PCI) 患者上部胃肠道出血 (UGIB) 的风险. 这些好处在各种高风险患者亚组中持续存在,尽管PPI没有增加缺血事件风险.
科学领域:
- 心脏病学 心脏病学
- 胃肠病学 胃肠病学
- 药理学 药理学是指药理学的学科.
背景情况:
- 质子抑制剂 (PPI) 通常用于接受皮肤冠状动脉干预 (PCI) 的患者.
- 之前的研究表明,PPI可能会降低这一群体上部胃肠道出血 (UGIB) 的风险.
- 在接受PCI的高风险子组中,PPI的差异性影响仍然不清楚.
研究的目的:
- 评估PPI在接受PCI的患者对UGIB的长期影响.
- 调查PPI福利是否在定义的高风险子组之间有所不同.
主要方法:
- 分析了来自CREDO-京都注册表的24,563名患者 (第2和第3组),他们接受了第一次PCI.
- 评估PPI使用及其与UGIB (GUSTO中度/重度出血) 之间的关联,平均随访时间为5.6年.
- 根据年龄,性别,急性冠状动脉综合征,高出血风险,口服抗凝剂使用以及P2Y12抑制剂类型进行了亚组分析.
主要成果:
- 45.6%的患者接受了PPI.
- PPI与显著较低的UGIB调整风险相关 (HR 0.64;P<0.001).
- 在PPI和GUSTO中度/重度出血 (HR1.04;P=0.40),心肌梗塞/缺血性中风 (HR1.00;P=0.97) 之间没有发现显著的关联,但调整后死亡风险更高 (HR1.18;P<0.001).
- PPI对UGIB,缺血事件和死亡率的影响在所有评估的高危子组中都是一致的.
结论:
- 在接受PCI的患者中,PPI与UGIB的风险降低有关.
- 针对UGIB的PPI的保护作用在各种高风险子组中是一致的.
- PPI显示出缺血事件的中性风险,但与该队列的死亡率增加有关.
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