在PCI后1个月以上的阿司匹林与克洛皮多格雷尔对比,在口服抗凝剂患者中
Masahiro Natsuaki1, Hirotoshi Watanabe2, Takeshi Morimoto3
1Department of Cardiovascular Medicine, Saga University, Japan (M.N.).
Circulation. Cardiovascular interventions
|September 24, 2025
概括
阿司匹林和克洛皮多格雷尔在经皮冠状动脉干预后长达一年的时间内显示出类似的心血管和出血结果,而不管口服抗凝剂 (OAC) 是否使用. 这一发现支持OAC患者PCI后的两种抗血小板选择.
科学领域:
- 心脏病学 心脏病学
- 药理学 药理学是指药理学的学科.
背景情况:
- 没有先前的研究比较阿司匹林与克洛皮多格勒与口服抗凝剂 (OAC) 在皮肤穿刺冠状动脉干预 (PCI) 后一年内.
- 在PCI后,通常建议使用OAC和克洛皮多格雷尔的双重治疗.
研究的目的:
- 为了比较阿司匹林与克洛皮多格雷尔在接受PCI的患者的疗效和安全性,有或没有OAC.
- 评估心血管和出血事件,直到PCI后的一年.
主要方法:
- 对STOPDAPT-3试验的子组分析,根据OAC使用对患者进行分层.
- 对比1个月的双重抗血小板疗法,其次是阿司匹林单疗法与1个月的普拉苏格勒单疗法,其次是克洛皮多格勒单疗法.
- 共同初级终点:心血管事件和出血学术研究联盟 (BARC) 3或5次出血事件.
主要成果:
- 在OAC患者中,阿司匹林的心血管事件率为3.7%,克洛皮多格雷尔为3.9% (HR 0.92).
- 在没有OAC的患者中,阿司匹林的心血管事件率为3.7%,克洛皮多格雷尔为3.6% (HR 1.03).
- 在阿司匹林和克洛皮多格雷尔组之间,无论有没有OAC,出血事件的发生率都相似.
结论:
- 阿司匹林和克洛皮多格雷尔在PCI后长达一年的时间内显示出相似的心血管和出血结果.
- 阿司匹林和克洛皮多格雷尔之间的治疗选择可能不会显著影响PCI后OAC患者的结果.
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