在患有先前心血管疾病的患者中发生重大胃肠道出血后心血管结果:INTERBLEED国际前性队列研究
Nauzer Forbes1, John W Eikelboom2, Qilong Yi2
1Division of Gastroenterology and Hepatology, University of Calgary, Calgary, Canada.
心血管疾病患者的胃肠道出血增加了死亡风险. 然而,在出血后恢复抗血栓治疗可能会减少主要的心血管不良事件和死亡.
科学领域:
- 心脏病学 心脏病学
- 胃肠病学 胃肠病学
- 临床研究 临床研究
背景情况:
- 胃肠道出血 (GIB) 是心血管 (CV) 疾病患者的常见并发症.
- 在这种高风险人群中,GIB后的结果尚未完全理解.
研究的目的:
- 评估已确诊心血管疾病的患者GIB的结果.
- 调查恢复抗血栓治疗和随后的临床事件之间的关联.
主要方法:
- 在INTERBLEED研究中,前性招募了3814名心血管疾病的成年患者,与GIB患者的1612名患者和没有GIB患者的2202名患者进行了比较.
- 在12个月评估的结果包括主要不良心血管事件 (MACE),全因死亡和复发性GIB.
- 使用多变量回归和生存分析.
主要成果:
- 在CV疾病患者中,GIB独立地与12个月全因死亡率 (OR 2.29) 和复发性GIB (OR 4.28) 的增加有关.
- 在GIB后4-30天恢复抗血栓治疗与停药相比,MACE风险显著降低.
- 招募后使用抗血栓剂与减少所有原因死亡 (OR 0.45) 相关,而不会增加复发性GIB风险.
结论:
- GIB是心血管疾病患者不良结果的独立预测因素,包括死亡率.
- 抗血栓管理策略,特别是及时恢复,显著影响GIB后心血管事件率.
- 进一步的研究至关重要,以建立在心血管疾病患者中GIB之后的最佳抗血栓治疗方案.
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