Lancet:桡动脉vs股动脉入径,比伐卢定vs肝素对急性冠状动脉综合征患者1年预后的影响

2018-09-08 zhangfan MedSci原创

研究认为急性冠状动脉综合征接受血管造影及PCI采用桡动脉入径后1年临床不良事件率较低,比伐卢定较肝素抗凝患者相比预后略微提高

MATRIX研究旨在考察抗凝药比伐卢定对急性冠状动脉综合征患者介入治疗的效果,近日研究人员公布了其1年随访研究结果。

研究在欧洲78个临床中心开展,ST段升高心肌梗死患者参与,接受血管造影及PCI的ACS患者,随机采用桡动脉入径和股动脉入径。接受抗凝治疗患者随机接受比伐卢定(1.75mg/kg/h)或普通肝素(70-100单位/kg/h,如有必要加用GP IIb/IIIa抑制剂, GP IIb/IIIa抑制剂治疗患者肝素剂量调整为50-70单位/kg/h)治疗。随访30天-1年,主要重点为主要血管不良事件(MACE,定义为30天死亡、心梗或卒中)和净不良临床事件(非冠状动脉旁路移植术后大出血或30天MACE)。

8404名患者参与研究,其4197人接受桡动脉入径,4207人接受股动脉入径。7213人接受抗凝治疗,其中比伐卢定组3610人,肝素组3603人。比伐卢定组患者中1799人接受术后输液,1811人未接受输液。1年后,桡动脉入径与股动脉入径组MACE差异不显著(14.2% vs 15.7%),但净不良临床事件率桡动脉入径组略低(15.2% vs 17.2%)。相比于肝素组,比伐卢定组MACE率(15.8% vs 16.8%)以及净不良临床事件率(17.0% vs 18.4%)略微降低。术后是否输液对急诊血管重建、直接血栓以及净不良临床事件发生影响不显著。

研究认为急性冠状动脉综合征接受血管造影及PCI采用桡动脉入径后1年临床不良事件率较低,比伐卢定较肝素抗凝患者相比预后略微提高。

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    2019-02-05 howi
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ipAttribution=)]
  5. 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attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmhead/Q3auHgzwzM6P57Bs8gOPaY1cQP9lIia0lmZOEXraGaoicqNToIslXDKw/0, createdBy=7a041951742, createdName=衣带渐宽, createdTime=Tue Sep 11 20:39:43 CST 2018, time=2018-09-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1431317, encodeId=fe80143131e3e, content=<a href='/topic/show?id=f9b9e9124a8' target=_blank style='color:#2F92EE;'>#综合征#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79124, encryptionId=f9b9e9124a8, topicName=综合征)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Mon Sep 10 01:57:00 CST 2018, time=2018-09-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1441105, encodeId=f0a9144110542, content=<a href='/topic/show?id=81a3623569c' target=_blank style='color:#2F92EE;'>#桡动脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=62356, encryptionId=81a3623569c, topicName=桡动脉)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ae384789560, createdName=12498aa2m63(暂无昵称), createdTime=Mon Sep 10 01:57:00 CST 2018, time=2018-09-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=344145, encodeId=ef683441456f, content=很好的学习机会, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2018/04/12/cd30eefc465f70dc4dad89bd57479781.jpg, createdBy=02be2318568, createdName=一天没事干, createdTime=Sun Sep 09 10:23:08 CST 2018, time=2018-09-09, status=1, ipAttribution=)]
    2018-09-17 13718711b3m

    学习了,非常不错的临床经验,值得借鉴,获益匪浅,谢谢分享!

    0

  6. 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attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmhead/Q3auHgzwzM6P57Bs8gOPaY1cQP9lIia0lmZOEXraGaoicqNToIslXDKw/0, createdBy=7a041951742, createdName=衣带渐宽, createdTime=Tue Sep 11 20:39:43 CST 2018, time=2018-09-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1431317, encodeId=fe80143131e3e, content=<a href='/topic/show?id=f9b9e9124a8' target=_blank style='color:#2F92EE;'>#综合征#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79124, encryptionId=f9b9e9124a8, topicName=综合征)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Mon Sep 10 01:57:00 CST 2018, time=2018-09-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1441105, encodeId=f0a9144110542, content=<a href='/topic/show?id=81a3623569c' target=_blank style='color:#2F92EE;'>#桡动脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=62356, encryptionId=81a3623569c, topicName=桡动脉)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ae384789560, createdName=12498aa2m63(暂无昵称), createdTime=Mon Sep 10 01:57:00 CST 2018, time=2018-09-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=344145, encodeId=ef683441456f, content=很好的学习机会, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2018/04/12/cd30eefc465f70dc4dad89bd57479781.jpg, createdBy=02be2318568, createdName=一天没事干, createdTime=Sun Sep 09 10:23:08 CST 2018, time=2018-09-09, status=1, ipAttribution=)]
    2018-09-11 衣带渐宽

    学习

    0

  7. 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attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmhead/Q3auHgzwzM6P57Bs8gOPaY1cQP9lIia0lmZOEXraGaoicqNToIslXDKw/0, createdBy=7a041951742, createdName=衣带渐宽, createdTime=Tue Sep 11 20:39:43 CST 2018, time=2018-09-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1431317, encodeId=fe80143131e3e, content=<a href='/topic/show?id=f9b9e9124a8' target=_blank style='color:#2F92EE;'>#综合征#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79124, encryptionId=f9b9e9124a8, topicName=综合征)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Mon Sep 10 01:57:00 CST 2018, time=2018-09-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1441105, 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  8. 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ipAttribution=)]
    2018-09-09 一天没事干

    很好的学习机会

    0

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