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在接受皮肤冠状动脉干预的癌症患者中,强大的P2Y12抑制剂与克洛皮多格雷尔对比
Mauro Gitto1, Samantha Sartori2, Birgit Vogel2
1Mount Sinai Fuster Heart Hospital, Icahn School of Medicine at Mount Sinai, New York, New York, USA; Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy.
强大的P2Y12抑制剂 (普拉苏格勒,蒂卡格勒) 在PCI后的癌症患者中显示出类似的出血风险,但与克洛皮多格雷尔相比,癌症患者的缺血事件较少. 这种益处主要出现在癌症缓解的患者中.
科学领域:
- 心脏病学 心脏病学
- 在瘤学瘤学.
- 药理学 药理学是指药理学的学科.
背景情况:
- 接受皮肤冠状动脉干预 (PCI) 的癌症患者面临缺血和出血事件的风险增加.
- 这项研究评估了这种高风险人群中强大的P2Y12抑制剂 (P2Y12i) 与克洛皮多格雷尔的对比.
研究的目的:
- 在接受PCI的癌症患者中,比较强效P2Y12抑制剂 (prasugrel,ticagrelor) 与克洛皮多格雷尔的安全性和有效性.
- 评估主要不良心脏和脑血管事件 (MACCE) 和重大出血的差异.
主要方法:
- 一项对1702名在2012-2022年期间接受PCI的癌症患者的回顾性研究.
- 使用倾向性得分调整来比较强效P2Y12i和克洛皮多格雷尔组之间的结果.
- 关键的终点包括MACCEs (死亡,心肌梗塞,中风) 和大出血在一年.
主要成果:
- 强效P2Y12i使用 (n=373) 与克洛皮多格雷尔 (n=1329) (调整HR为0.53,P=0.035) 相比,与较低的MACCE率 (3.5%对6.8%) 有关.
- 两组之间没有观察到重大出血风险的显著差异 (5.5%对7.0%).
- 在癌症缓解的患者中,MACCEs的减少是显著的,但在活跃癌症患者中没有 (P相互作用=0.011).
结论:
- 强大的P2Y12抑制剂在减少缺血事件方面具有潜在的益处,而不会增加PCI后癌症患者的出血风险.
- 这些发现表明,在选择P2Y12抑制剂时,需要采用个性化的方法,考虑癌症状况 (缓解与活跃).
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