在接受皮肤冠状动脉干预的癌症患者中验证高出血风险定义
Mauro Gitto1,2, Sean Gilhooley1, Kenneth Smith1
1Mount Sinai Fuster Heart Hospital, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
European journal of preventive cardiology
|December 21, 2024
概括
一个适应的出血风险工具可以有效地识别患有高风险出血和死亡的经皮冠状动脉干预 (PCI) 的癌症患者. 这一验证的标准改善了这个脆弱人群的风险分层.
科学领域:
- 心脏病学 心脏病学
- 在瘤学瘤学.
- 干预心脏病学 干预心脏病学
背景情况:
- 对于接受皮肤冠状动脉干预 (PCI) 的癌症患者,缺乏经过验证的出血风险工具.
- 癌症患者代表了一个独特的人群,在PCI手术过程中可能会改变出血风险.
研究的目的:
- 在接受PCI的癌症患者中验证学术研究联盟 (ARC) 高出血风险 (HBR) 标准的适应版本.
- 评估适应的ARC-HBR标准在预测出血事件和重大心脏和脑血管不良事件 (MACCE) 中的有用性.
主要方法:
- 分析了一组连续的2,007名在2012年至2022年间接受PCI的癌症患者队列.
- 如果患者符合特定的ARC-HBR标准 (不包括癌症作为主要标准),则被归类为HBR.
- 主要终点:1年后的复合出血;次要终点:MACCE (死亡,心肌梗塞,中风).
主要成果:
- 56.9%的癌症患者被归类为HBR,贫血是最常见的标准.
- 一年后,HBR患者的出血发生率显著增加 (10.9%对3.9%,调整HR:2.36).
- HBR分类也与MACCE风险增加有关 (11.0%与3.2%,调整HR:2.78) 和死亡 (8.8%与2.2%,调整HR:3.28).
结论:
- 适应的ARC-HBR标准有效地识别了接受PCI的高出血风险的癌症患者.
- 根据这种适应的标准,被确定为HBR的癌症患者面临着明显更高的死亡风险.
- 这种经过验证的工具可以帮助临床决策和PCI癌症患者的风险分层.
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