在没有先前使用抗血小板的第一次缺血性中风中对抗血小板的治疗模式的分析:使用共同数据模型对11个韩国观察数据库的真实世界分布式网络分析
Soo-Hyun Park1, Kyung Joo Lee2, Jinseob Kim3
1Department of Neurology, Soonchunhyang University Seoul Hospital, Seoul, Korea.
Journal of Korean medical science
|December 23, 2025
概括
CHANCE试验显著改变了韩国缺血性中风患者的抗血小板处方,增加了双重抗血小板治疗的使用. 阿司匹林仍然很常见,但组合疗法现在在试验后领先.
科学领域:
- 心脏病学 心脏病学
- 神经学 神经学
- 药理学 药理学是指药理学的学科.
背景情况:
- 心血管疾病是全球死亡的主要原因,在韩国排名第二.
- 抗血小板剂对于预防心血管事件至关重要.
- 了解现实世界的抗血小板处方模式是必不可少的,因为需求日益增加.
研究的目的:
- 分析韩国首次缺血性中风 (IS) 患者的抗血小板处方趋势.
- 评估2013年CHANCE试验对处方模式的影响.
主要方法:
- 使用11个韩国观察数据库 (1995-2023) 对162,361名首次发生IS患者的分析.
- 数据转换为一个共同的数据模型.
- 与CHANCE试验出版物相关的处方轮班进行了评估.
主要成果:
- 最初的抗血小板治疗:阿司匹林 (39.4%),阿司匹林-克洛皮多格雷尔 (28.2%),克洛皮多格雷尔 (13.7%).
- 机会后试验:阿司匹林-克洛皮多格雷尔组合成为主导 (40.6%),其次是阿司匹林 (30.3%) 和克洛皮多格雷尔 (11.3%) 单疗法.
- 在CHANCE试验之后,对双重抗血小板治疗 (DAPT) 的显著转变.
结论:
- CHANCE试验显著影响了DAPT在二次性IS预防中的使用.
- 阿司匹林仍然是主要的药物,但DAPT的使用显著增加.
- 对抗血小板模式的持续分析对于在临床实践中实施指南至关重要.
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