单抗血小板疗法与双抗血小板疗法用于预防中风的患者有史以来第一次血栓性中风的不确定的来源
Minwoo Lee1,2, Chulho Kim2,3, Jong-Hee Sohn2,3
1Department of Neurology, Hallym Sacred Heart Hospital, Hallym University College of Medicine, Anyang, South Korea.
概括
双抗血小板治疗 (DAPT) 与单抗血小板治疗 (SAPT) 相比,在源不明的栓塞性中风 (ESUS) 患者中显著降低了缺血事件. 在3年内,DAPT没有显示出严重出血的风险增加.
科学领域:
- 心脏病学 心脏病学
- 神经学 神经学
- 临床试验 临床试验
背景情况:
- 源不明的栓塞性中风 (ESUS) 是一个治疗挑战.
- 评估抗血小板策略对于ESUS患者的二次中风预防至关重要.
研究的目的:
- 为了比较双抗血小板治疗 (DAPT) 与单抗血小板治疗 (SAPT) 的疗效和安全性.
- 评估患有首次源不明血栓性中风 (ESUS) 的患者的结局.
主要方法:
- 多中心队列研究与倾向性得分匹配 (PSM) 子集.
- 主要结局:复发性缺血性中风,心肌梗塞或全因死亡的组合.
- 安全结果:严重出血;随访时间长达3年.
主要成果:
- 与SAPT相比,DAPT显著降低了复合结果的危险性 (aHR=0.56) 在总队列 (n=1675) 中.
- 通过DAPT观察到中风复发和死亡率的减少;在重大出血方面没有显著差异.
- DAPT对缺血的益处在6-12个月之间最明显,持续长期;出血风险没有显著增加.
结论:
- 双重抗血小板治疗 (DAPT) 与ESUS患者的缺血事件减少有关,而不会增加重大出血风险.
- DAPT的治疗效益很早 (6-12个月) 很明显,并在长时间的随访期间持续.
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