在接受PCI的高出血风险女性和男性中,为期1个月或3个月的DAPT
Vijay Kunadian1, Mauro Gitto2, Birgit Vogel3
1Translational and Clinical Research Institute, Newcastle University and Cardiothoracic Centre, Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom.
JACC. Cardiovascular interventions
|February 19, 2025
概括
穿皮冠状动脉干预 (PCI) 后的短期双重抗血小板治疗 (DAPT) 对高出血风险患者是安全的. 与三个月的DAPT相比,一个月的DAPT显示出类似的缺血事件率和数值较低的出血,无论性别如何.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 临床试验 临床试验
背景情况:
- 短暂的双重抗血小板治疗 (DAPT) 减少出血,并保持高出血风险 (HBR) 患者的缺血保护,在皮肤冠状动脉干预 (PCI) 后.
- 评估最佳的DAPT持续时间对于在接受PCI的HBR患者中平衡疗效和安全至关重要.
研究的目的:
- 为了比较一个月和三个月的DAPT疗法,然后在HBR接受PCI的女性和男性中进行阿司匹林单疗法.
- 以性别分层的方式评估短时间DAPT的安全性和有效性.
主要方法:
- 来自三项前性国际研究 (XIENCE 简短 DAPT 计划) 的数据分析,涉及使用 XIENCE 常利释放支架治疗的 HBR 患者.
- 主要终点:死亡或心肌梗塞 (MI) 一年后的复合结果.
- 关键次要终点:出血学术研究联盟 (BARC) 2至5型出血.
主要成果:
- 在3364名患者 (34.3%的女性) 中,女性和男性的一年死亡率或心脏病发作率相似 (7.6%对8.1%).
- 一个月和三个月的DAPT显示,女性和男性的死亡或心脏病发作风险相似 (相互作用P=0.783).
- 一个月的DAPT显示,两性BARC类型2-5出血的数量较低,尽管在倾向分数分层后 (P对相互作用=0.378) 统计学上不显著.
结论:
- 一个月和三个月的DAPT疗法与HBR患者接受PCI的患者具有类似的缺血事件风险,无论性别如何.
- 一个月的DAPT导致男性和女性的临床相关性出血数量较少,尽管分层后的差异在统计学上并不显著.
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