周围动脉疾病和抗血栓治疗管理:关于有效性,安全性和获取的全球视角
Abbas Mohammadi1, Yasaman Vaseghi1, Ali Rafatnia1
1From the Department of Medicine, Valley Health System, Las Vegas, NV.
Cardiology in review
|June 26, 2025
概括
双通道抑制 (DPI) 在外周动脉疾病 (PAD) 患者中显著减少心血管和四肢事件. 然而,出血的风险和获取差异挑战了它对这种广泛存在的疾病的全球实施.
科学领域:
- 心血管医学 心血管医学
- 血管外科 血管外科
- 药理学 药理学是指药理学的学科.
背景情况:
- 周围动脉疾病 (PAD) 影响全球超过2.3亿人,是系统性动脉样硬化的严重表现.
- PAD的进展包括血栓形成,内皮功能障碍,血小板激活和血栓生成,导致关键四肢缺血和心血管事件.
- 抗血小板治疗对于PAD管理至关重要,传统的抗血小板单一治疗作为一线治疗.
研究的目的:
- 评估双通道抑制 (DPI) 在管理周围动脉疾病 (PAD) 的影响.
- 评估在PAD患者中将低剂量里瓦洛克萨班与阿司匹林结合使用的疗效和安全性.
- 分析目前的指导方针建议和PAD治疗的新兴策略.
主要方法:
- 对PAD中双通道抑制 (DPI) 的临床试验数据的审查.
- 分析主要心血管学会 (AHA/ACC,ESC) 的指导方针建议.
- 探索新兴的治疗策略,包括抗炎药物和再生医学.
主要成果:
- 低剂量里瓦洛克萨班和阿司匹林的双通道抑制 (DPI) 减少了24%的主要心血管不良事件和46%的肢体事件.
- 在高风险小组中,DPI表现出特别有益的效果,例如在重血管化后或慢性肢体威胁性缺血症患者中.
- 目前的指导方针显示DPI的不同认可,反映了正在进行的风险效益评估.
结论:
- 双通道抑制 (DPI) 代表了PAD管理的重大进步,比传统的抗血小板单一疗法提供更高的疗效.
- 流血风险和全球访问差异仍然是广泛采用DPI的关键挑战.
- 未来的PAD护理需要个性化策略,整合抗血栓效益,减轻出血和社会经济因素,以及对新疗法的研究和改善获取.
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