多药对为外围动脉疾病进行重血管治疗的患者的影响
Philipp Franke1, Emmanuel Katsogridakis2, Theodosios Bisdas1,3
1Department of Vascular and Endovascular Surgery, St. Franziskus-Hospital, Muenster, Germany.
多药性,即使用五种或五种以上的药物,与经过再血管化治疗的外周动脉疾病 (PAD) 患者的治疗结果更差有关. 虽然它不会增加截肢的主要风险,但它预测了更高的死亡率,心血管事件和重新干预.
科学领域:
- 血管外科 血管外科
- 临床药理学 临床药理学
- 心脏病学 心脏病学
背景情况:
- 周围动脉疾病 (PAD) 影响着众多患者,通常需要重新血管化手术.
- 多药性,定义为同时使用五种或更多种药物,在这个患者群体中很常见.
- 多药对PAD再血管化的结果的影响仍然不完全理解.
研究的目的:
- 为了研究多药和临床结果之间的关联,在患者接受了症状PAD的重血管化.
- 确定多药性是否是不良事件的独立预测因素,包括无截肢生存率,死亡率和主要心脏-脑血管事件 (MACCE).
主要方法:
- 在2017年1月至2017年12月期间连续治疗560名PAD患者的回顾性分析.
- 主要终点:截肢和/或死亡的组合 (无截肢生存率;AFS).
- 考克斯回归和倾向分数匹配分析被用来评估多药的影响,控制混因素.
主要成果:
- 73%的患者 (409/560) 符合多药的标准.
- 多种药物独立预测了死亡 (HR 4.72),MACCE (HR 2.82),重新干预 (HR 1.51) 和AFS (HR 3.46).
- 倾向性得分匹配证实了多药与心血管死亡,MACCE和重新干预的风险增加的联系,但没有重大截肢.
结论:
- 多药性是患者不良临床结果的独立预测者,这些患者正在接受症状PAD的重血管化治疗.
- 这些发现凸显了这种高风险群体中药物管理的重要性.
- 在这个队列中,多药性并没有显著影响主要四肢截肢的风险.
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