单抗血小板治疗与双抗血小板治疗对凝血/血栓形成后PAD再血管化的影响
Adriana A Rodriguez Alvarez1, Shiv S Patel1, Isabella F Cieri1
1Division of Vascular and Endovascular Surgery, Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA.
Science progress
|March 4, 2025
概括
双抗血小板治疗 (DAPT) 显示出较低的血栓前形状,但并没有减少外周动脉疾病患者的初始血栓事件. 在公开程序中,DAPT可以减少在初始事件后的反复事件.
科学领域:
- 血管外科 血管外科
- 药理学 药理学是指药理学的学科.
- 心脏病学 心脏病学
背景情况:
- 周围动脉疾病 (PAD) 的管理通常涉及下肢再血管化.
- 抗血小板治疗对于预防手术后发生的血栓事件至关重要.
- 将单抗血小板治疗 (SAPT) 和双抗血小板治疗 (DAPT) 进行比较对于优化结果至关重要.
研究的目的:
- 为了比较SAPT与DAPT对凝血概况的影响.
- 为了评估下肢再血管化的PAD患者的术后结果.
- 评估SAPT与DAPT的血栓事件 (TEs) 的发生率.
主要方法:
- 对157名经过下肢再血管化的PAD患者进行前性队列研究.
- 患者被跟踪了一年,以记录血栓事件 (TE).
- 干预通过开放式与内血管方法和SAPT与DAPT方案分层;使用t测试,费舍尔精确测试,卡普兰-梅尔曲线和考克斯比例危险模型进行统计分析.
主要成果:
- 与SAPT接受者相比,DAPT接受者表现出较低的原血栓状况 (p < 0.05).
- 在每个队列中,SAPT和DAPT组之间的指数TE发生率没有显著差异.
- 在开放干预组 (p < 0.001) 中,DAPT与复发性TEs的减少有关.
- 在内血管和开放手术之间或在DAPT和SAPT组之间,血栓形成的概率没有显著差异.
结论:
- 虽然DAPT显示出更好的凝血概况,但它并没有减少跨手术模式的索引血栓事件.
- 在开放式重血管化中,DAPT可能在减少在开放式重血管化初始事件后复发的血栓性并发症方面发挥作用.
- 目前的证据表明,内血管和开放手术之间,或SAPT和DAPT组之间,血栓形成概率没有显著差异.
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