在急性缺血性中风或短暂缺血性发作中,双重抗血小板治疗与单独阿司匹林相比:随机对照试验的元分析和试验顺序分析
Ramez M Odat1, Sakhr Alshwayyat2,3,4, Zainab I Bahdar5
1Faculty of Medicine, Jordan University of Science and Technology, Jordan.
The Journal of international medical research
|May 14, 2025
概括
双重抗血小板治疗减少了复发性缺血性中风和主要不良心血管事件,但增加了出血性中风的风险. 证据支持其用于预防缺血事件,但需要对出血事件和死亡率进行更多研究.
科学领域:
- 神经学 神经学
- 心脏病学 心脏病学
- 临床试验 临床试验
背景情况:
- 对于缺血性中风和短暂缺血性发作 (TIA) 的双重抗血小板治疗 (DAPT) 有有限的数据.
- 与单独阿司匹林相比,了解DAPT的疗效和安全性对于患者管理至关重要.
研究的目的:
- 在急性缺血性中风或TIA患者中,系统地审查和分析DAPT与单独阿司匹林的疗效和安全性.
- 评估复发性缺血性中风,心血管事件和出血的风险.
主要方法:
- 搜索了主要的数据库 (PubMed,Embase,Scopus,Cochrane,Web of Science) 截至2024年8月.
- 包括随机对照试验,比较DAPT与单独的阿司匹林.
- 进行了聚合风险比率分析和试验顺序分析.
主要成果:
- 包括5项涉及27,563名患者的研究.
- DAPT显著减少了复发性缺血性中风 (RR 0.74) 和主要不良心血管事件 (RR 0.77).
- DAPT显著增加了复发性出血性中风 (RR 2.13) 和出血风险 (RR 2.21).
结论:
- 与单独使用阿司匹林相比,DAPT显示复发性缺血性中风和主要不良心血管事件的发生率较低.
- 有足够的证据支持DAPT预防缺血事件和出血.
- 需要进一步研究复发性出血性中风和全因死亡的结果.
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