JAMA:早期强化降压对急性缺血性脑卒中预后无益(CATIS研究)

2013-11-19 医者仁心1993 dxy

2013年11月17日,德克萨斯州达拉斯AHA2013年会消息,美国杜兰大学何江教授带领的研究团队开展的CATIS研究表明:早期强化抗高血压治疗无益于急性缺血性脑卒中患者预后。 卒中是全球第二大死因,其死亡率和致残率极高,造成极大的社会负担,临床试验已证实,有过卒中或短暂性脑缺血发作病史的患者,其血压高或正常,降低血压有利减少卒中的风险。尽管降低血压有利于卒中的初级预防和二级预防已得到证实,但在

2013年11月17日,德克萨斯州达拉斯AHA 2013年会消息,针对这种情况,来自美国路易斯安那州新奥尔良杜兰大学医学院公共卫生和热带医学院流行病学系的何江教授(He Jiang音译)带领的研究团队开展的CATIS研究表明:早期强化抗高血压治疗无益于急性缺血性脑卒中患者预后。该论文入选2013年12月16日—20日在美国德克萨斯州达拉斯会议中心召开的美国心脏协会(AHA)科学年会,并在线发表于2013年11月17日《美国医学会杂志》( Journal of the American Medical Association)上,发现早期强化抗高血压治疗无益于急性缺血性脑卒中患者预后。

卒中是全球第二大死因,其死亡率和致残率极高,造成极大的社会负担,临床试验已证实,有过卒中或短暂性脑缺血发作病史的患者,其血压高或正常,降低血压有利减少卒中的风险。尽管降低血压有利于卒中的初级预防和二级预防已得到证实,但在患者发生急性缺血性脑卒中时,直接抗高血压治疗的效果却未得到证明。

高血压在急性缺血性脑卒中患者上很常见。根据美国全国非卧床病人医疗护理调查显示,76.5%的患者发生急性缺血性脑卒中时,收缩压达到了140mm Hg,在刚到达急诊科时也许更高。已有观察性研究报道,在患者发生急性缺血性脑卒中时,症状出现后的48h内,血压下降在临床不良预后方面表现较好、较差或并无差异,其结论并不统一。目前,并无具有足够统计学证据的研究去证实在患者发生急性缺血性脑卒中时,降低血压能降低其不良预后。

尽管已证实降低血压有利于卒中的初级预防和二级预防,但患者发生急性缺血性脑卒中时,降低血压的作用对预后依然不确定,这些研究的目的是评估在出院或14天内,直接降低急性缺血性卒中患者的血压是否可以减少患者的死亡率和重度残疾。

中国急性缺血性脑卒中降压试验(CATIS)是一项单盲,终点双盲的随机临床试验,从2009年8月至2013年5月在中国26所医院招募2038位发生急性缺血性脑卒中时48h未溶栓且收缩压升高的患者。患者(n=2038)被随机分配接受抗高血压治疗(在随机分配后24h内,降压目标为降低10%-25%的收缩压,7天内降压目标为少于140/90mm Hg,并在住院期间维持这一水平)。而对照组患者(n=2033)住院期间不经任何抗高血压治疗。主要终点为:14天内的死亡率和重度残疾(改良Rankin量表分≥3)或患者在出院

在随机化分组24h内,实验组:经过抗高血压治疗后,平均收缩压从166.7mm Hg降至144.7mm Hg(降幅为12.7%);对照组:不经抗高血压治疗,平均收缩压从165.6mm Hg降至152.9mm Hg(降幅为7.2%),两者之间有绝对差异,为-9.1mm Hg(P<0.001) [95% CI, −10.2 to −8.1]; P < .001)。在随机化分组7天时,实验组平均收缩压为137.3mm Hg;对照组为146.6mm Hg,有差异,-9.3 mm Hg [95% CI, −10.1 to −8.4]; p < .001)。

主要终点显示,在随机化后14天内,接受早期强化降压的实验组中发生了683例事件,而对照组中为681例事件,实验组与对照组之间并无差异(odds ratio, 1.00 [95% CI, 0.88 to 1.14]; P = .98) ;在随机化分组3个月时随访,并综合患者死亡率和重度残疾得知,实验组发生了500例事件,对照组为502例事件,两者之间并无差异 (odds ratio, 0.99 [95% CI, 0.86 to 1.15]; P = .93).。

因此,在患者发生急性缺血性脑卒中时,早期强化抗高血压治疗与未经抗高血压治疗对于患者预后并无差异,并不能减少患者在14天内或出院的死亡率和重大残疾。

值得一提的是,来自迈阿密大学神经病学系主席Ralph Sacco博士说,需要慎重解读这些研究的结果,尽管这些研究具有足够统计学证据,但是具有一定的地域性,在中国,发生卒中往往在颅内大动脉,但在美国却非如此。此外,目前美国卒中协会指南推荐在溶栓治疗和血压显著增高(220mmHg/120mmHg)的患者中采用降压治疗降低收缩压,而这两部分患者是排除在中国急性缺血性脑卒中降压试验研究之外的。

因此,AHA前任主席Sacco说,中国急性缺血性脑卒中降压试验研究结果并不能产生改变指南的证据,尽管研究结果为阴性,Sacco说仍有一些在卒中治疗中需要注意的事项:首先,该研究再次证实如果血压没有显著升高,在急性期我们不需要强化治疗;3个月的数据提示对复发性卒中存在可能的获益,尽管没有显著统计学差异。还有一些学者表明在该研究中提示在症状发生之后24小时后开始降压可能是安全的,但是何时开始启动药物治疗的决策应该是遵循个体化原则。

原始出处:

He J, Zhang Y, Xu T, Zhao Q, Wang D, Chen CS, Tong W, Liu C, Xu T, Ju Z, Peng Y, Peng H, Li Q, Geng D, Zhang J, Li D, Zhang F, Guo L, Sun Y, Wang X, Cui Y, Li Y, Ma D, Yang G, Gao Y, Yuan X, Bazzano LA, Chen J; for the CATIS Investigators.Effects of Immediate Blood Pressure Reduction on Death and Major Disability in Patients With Acute Ischemic Stroke: The CATIS Randomized Clinical Trial. JAMA. 2013 Nov 17. doi: 10.1001/jama.2013.282543.

原文下载:PDF

版权声明:
本网站所有内容来源注明为“梅斯医学”或“MedSci原创”的文字、图片和音视频资料,版权均属于梅斯医学所有。非经授权,任何媒体、网站或个人不得转载,授权转载时须注明来源为“梅斯医学”。其它来源的文章系转载文章,或“梅斯号”自媒体发布的文章,仅系出于传递更多信息之目的,本站仅负责审核内容合规,其内容不代表本站立场,本站不负责内容的准确性和版权。如果存在侵权、或不希望被转载的媒体或个人可与我们联系,我们将立即进行删除处理。
在此留言
评论区 (5)
#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=1892592, encodeId=d56818925920f, content=<a href='/topic/show?id=c738e93521f' target=_blank style='color:#2F92EE;'>#缺血性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79352, encryptionId=c738e93521f, topicName=缺血性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=66ec123, createdName=guihongzh, createdTime=Sun Jul 13 22:48:00 CST 2014, time=2014-07-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1806983, encodeId=7d7a180698332, content=<a href='/topic/show?id=245de9378aa' target=_blank style='color:#2F92EE;'>#缺血性脑#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79378, encryptionId=245de9378aa, topicName=缺血性脑)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTLGtr9t89oicQdQSIeKmOQic1weIWfibJ7H24XnT8ic9wiaUMTnXByenuwicOj8Jib42ibHXNptnuiaKthhiaVw/132, createdBy=ac342500190, createdName=ms7524819409032184, createdTime=Sat Dec 07 23:48:00 CST 2013, time=2013-12-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1259340, encodeId=556b1259340ef, content=<a href='/topic/show?id=5679523e201' target=_blank style='color:#2F92EE;'>#急性缺血性脑卒中#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=52372, encryptionId=5679523e201, topicName=急性缺血性脑卒中)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=568152, createdName=snowpeakxu, createdTime=Thu Nov 21 07:48:00 CST 2013, time=2013-11-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1291805, encodeId=3801129180507, content=<a href='/topic/show?id=9d32981418b' target=_blank style='color:#2F92EE;'>#降压#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98141, encryptionId=9d32981418b, topicName=降压)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8f14236, createdName=经常头晕, createdTime=Thu Nov 21 07:48:00 CST 2013, time=2013-11-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1419059, encodeId=c1db14190591c, content=<a href='/topic/show?id=e051501461d' target=_blank style='color:#2F92EE;'>#强化降压#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=50146, encryptionId=e051501461d, topicName=强化降压)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=2c6c3470765, createdName=fengxx, createdTime=Thu Nov 21 07:48:00 CST 2013, time=2013-11-21, status=1, ipAttribution=)]
  2. [GetPortalCommentsPageByObjectIdResponse(id=1892592, encodeId=d56818925920f, content=<a href='/topic/show?id=c738e93521f' target=_blank style='color:#2F92EE;'>#缺血性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79352, encryptionId=c738e93521f, topicName=缺血性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=66ec123, createdName=guihongzh, createdTime=Sun Jul 13 22:48:00 CST 2014, time=2014-07-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1806983, encodeId=7d7a180698332, content=<a href='/topic/show?id=245de9378aa' target=_blank style='color:#2F92EE;'>#缺血性脑#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79378, encryptionId=245de9378aa, topicName=缺血性脑)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTLGtr9t89oicQdQSIeKmOQic1weIWfibJ7H24XnT8ic9wiaUMTnXByenuwicOj8Jib42ibHXNptnuiaKthhiaVw/132, createdBy=ac342500190, createdName=ms7524819409032184, createdTime=Sat Dec 07 23:48:00 CST 2013, time=2013-12-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1259340, encodeId=556b1259340ef, content=<a href='/topic/show?id=5679523e201' target=_blank style='color:#2F92EE;'>#急性缺血性脑卒中#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=52372, encryptionId=5679523e201, topicName=急性缺血性脑卒中)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=568152, createdName=snowpeakxu, createdTime=Thu Nov 21 07:48:00 CST 2013, time=2013-11-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1291805, encodeId=3801129180507, content=<a href='/topic/show?id=9d32981418b' target=_blank style='color:#2F92EE;'>#降压#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98141, encryptionId=9d32981418b, topicName=降压)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8f14236, createdName=经常头晕, createdTime=Thu Nov 21 07:48:00 CST 2013, time=2013-11-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1419059, encodeId=c1db14190591c, content=<a href='/topic/show?id=e051501461d' target=_blank style='color:#2F92EE;'>#强化降压#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=50146, encryptionId=e051501461d, topicName=强化降压)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=2c6c3470765, createdName=fengxx, createdTime=Thu Nov 21 07:48:00 CST 2013, time=2013-11-21, status=1, ipAttribution=)]
  3. [GetPortalCommentsPageByObjectIdResponse(id=1892592, encodeId=d56818925920f, content=<a href='/topic/show?id=c738e93521f' target=_blank style='color:#2F92EE;'>#缺血性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79352, encryptionId=c738e93521f, topicName=缺血性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=66ec123, createdName=guihongzh, createdTime=Sun Jul 13 22:48:00 CST 2014, time=2014-07-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1806983, encodeId=7d7a180698332, content=<a href='/topic/show?id=245de9378aa' target=_blank style='color:#2F92EE;'>#缺血性脑#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79378, encryptionId=245de9378aa, topicName=缺血性脑)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTLGtr9t89oicQdQSIeKmOQic1weIWfibJ7H24XnT8ic9wiaUMTnXByenuwicOj8Jib42ibHXNptnuiaKthhiaVw/132, createdBy=ac342500190, createdName=ms7524819409032184, createdTime=Sat Dec 07 23:48:00 CST 2013, time=2013-12-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1259340, encodeId=556b1259340ef, content=<a href='/topic/show?id=5679523e201' target=_blank style='color:#2F92EE;'>#急性缺血性脑卒中#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=52372, encryptionId=5679523e201, topicName=急性缺血性脑卒中)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=568152, createdName=snowpeakxu, createdTime=Thu Nov 21 07:48:00 CST 2013, time=2013-11-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1291805, encodeId=3801129180507, content=<a href='/topic/show?id=9d32981418b' target=_blank style='color:#2F92EE;'>#降压#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98141, encryptionId=9d32981418b, topicName=降压)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8f14236, createdName=经常头晕, createdTime=Thu Nov 21 07:48:00 CST 2013, time=2013-11-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1419059, encodeId=c1db14190591c, content=<a href='/topic/show?id=e051501461d' target=_blank style='color:#2F92EE;'>#强化降压#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=50146, encryptionId=e051501461d, topicName=强化降压)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=2c6c3470765, createdName=fengxx, createdTime=Thu Nov 21 07:48:00 CST 2013, time=2013-11-21, status=1, ipAttribution=)]
  4. [GetPortalCommentsPageByObjectIdResponse(id=1892592, encodeId=d56818925920f, content=<a href='/topic/show?id=c738e93521f' target=_blank style='color:#2F92EE;'>#缺血性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79352, encryptionId=c738e93521f, topicName=缺血性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=66ec123, createdName=guihongzh, createdTime=Sun Jul 13 22:48:00 CST 2014, time=2014-07-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1806983, encodeId=7d7a180698332, content=<a href='/topic/show?id=245de9378aa' target=_blank style='color:#2F92EE;'>#缺血性脑#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79378, encryptionId=245de9378aa, topicName=缺血性脑)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTLGtr9t89oicQdQSIeKmOQic1weIWfibJ7H24XnT8ic9wiaUMTnXByenuwicOj8Jib42ibHXNptnuiaKthhiaVw/132, createdBy=ac342500190, createdName=ms7524819409032184, createdTime=Sat Dec 07 23:48:00 CST 2013, time=2013-12-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1259340, encodeId=556b1259340ef, content=<a href='/topic/show?id=5679523e201' target=_blank style='color:#2F92EE;'>#急性缺血性脑卒中#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=52372, encryptionId=5679523e201, topicName=急性缺血性脑卒中)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=568152, createdName=snowpeakxu, createdTime=Thu Nov 21 07:48:00 CST 2013, time=2013-11-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1291805, encodeId=3801129180507, content=<a href='/topic/show?id=9d32981418b' target=_blank style='color:#2F92EE;'>#降压#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98141, encryptionId=9d32981418b, topicName=降压)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8f14236, createdName=经常头晕, createdTime=Thu Nov 21 07:48:00 CST 2013, time=2013-11-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1419059, encodeId=c1db14190591c, content=<a href='/topic/show?id=e051501461d' target=_blank style='color:#2F92EE;'>#强化降压#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=50146, encryptionId=e051501461d, topicName=强化降压)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=2c6c3470765, createdName=fengxx, createdTime=Thu Nov 21 07:48:00 CST 2013, time=2013-11-21, status=1, ipAttribution=)]
  5. [GetPortalCommentsPageByObjectIdResponse(id=1892592, encodeId=d56818925920f, content=<a href='/topic/show?id=c738e93521f' target=_blank style='color:#2F92EE;'>#缺血性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79352, encryptionId=c738e93521f, topicName=缺血性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=66ec123, createdName=guihongzh, createdTime=Sun Jul 13 22:48:00 CST 2014, time=2014-07-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1806983, encodeId=7d7a180698332, content=<a href='/topic/show?id=245de9378aa' target=_blank style='color:#2F92EE;'>#缺血性脑#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79378, encryptionId=245de9378aa, topicName=缺血性脑)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTLGtr9t89oicQdQSIeKmOQic1weIWfibJ7H24XnT8ic9wiaUMTnXByenuwicOj8Jib42ibHXNptnuiaKthhiaVw/132, createdBy=ac342500190, createdName=ms7524819409032184, createdTime=Sat Dec 07 23:48:00 CST 2013, time=2013-12-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1259340, encodeId=556b1259340ef, content=<a href='/topic/show?id=5679523e201' target=_blank style='color:#2F92EE;'>#急性缺血性脑卒中#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=52372, encryptionId=5679523e201, topicName=急性缺血性脑卒中)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=568152, createdName=snowpeakxu, createdTime=Thu Nov 21 07:48:00 CST 2013, time=2013-11-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1291805, encodeId=3801129180507, content=<a href='/topic/show?id=9d32981418b' target=_blank style='color:#2F92EE;'>#降压#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98141, encryptionId=9d32981418b, topicName=降压)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8f14236, createdName=经常头晕, createdTime=Thu Nov 21 07:48:00 CST 2013, time=2013-11-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1419059, encodeId=c1db14190591c, content=<a href='/topic/show?id=e051501461d' target=_blank style='color:#2F92EE;'>#强化降压#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=50146, encryptionId=e051501461d, topicName=强化降压)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=2c6c3470765, createdName=fengxx, createdTime=Thu Nov 21 07:48:00 CST 2013, time=2013-11-21, status=1, ipAttribution=)]

相关资讯

AHA:踝臂指数检测与判读新标准

11 月 16 日,《循环》(Circulation)杂志在线发表了美国心脏学会(AHA)“关于踝臂指数(ABI)检测与结果解读的科学声明”。声明回顾了ABI 相关研究,推荐了确定 ABI的标准方法,就如何解读结果提出了指导意见,并就科学文献对ABI数据报告的一致性推荐了标准。 关于ABI检测的价值和应用前景,中山大学附属第一医院高血压血管病科陶军教授应邀发表了观点。他指出,动脉粥样硬化是一个漫

AHA 2013:机械式胸外按压有效性并不优于人工胸外按压

大规模临床随机试验比较机械式胸外按压与人工胸外按压的有效性。研究主要终点指标为4小时存活率。机械式胸外按压有效性并不优于人工胸外按压机械式胸外按压目前特别适用于特定人群机械式按压应该可以改善院外心脏骤停患者的预后,但目前尚无大规模临床试验提供足够的证据。与传统人工胸外按压心肺复苏相比,机械式胸外按压心肺复苏和除颤是否能改善4小时存活率?来自瑞典乌普萨拉大学医院的Sten Rubertss

Stroke:2012AHA口服抗凝药治疗非瓣膜性房颤卒中建议

        2012年8月2日,《卒中》(Stroke)杂志在线发表了美国心脏学会(AHA)/美国卒中学会(ASA)有关口服抗栓药预防非瓣膜性房颤卒中的科学建议。该科学建议针对新型口服抗凝药作出了13项新推荐,并指出,达比加群、利伐沙班、阿哌沙班的临床应用仍有相关的未解决问题,这些药物之间并没有直接对比的数据,而都是与华法林作比较。临

JACC:改良干细胞促进衰老心肌修复

     近期,美国心脏学会(AHA)心血管基础科学2012年科学会议的一篇报道指出,基因修饰的干细胞可促进衰老心脏细胞的活力,用于老年心力衰竭患者体内受损和衰老心肌组织的再生。这项研究有朝一日可能引领出新的心力衰竭治疗方法。该研究同时发表在2012年7月26日的《美国心脏病学会杂志》。  主要研究者之一、美国圣迭戈州立大学心脏研究所博士后研究学者萨迪亚·穆

2012AHA科学共识 机械循环支持使用建议:设备策略和病人选择

     Jennifer L Peura博士(南卡罗来纳医科大学)提到,这是AHA为“该领域不具备MCS技术的咨询医生,包括普通心脏病学家或内科主治医师制定的建议。目的是希望,这些建议可以使更多的心脏衰竭患者得以在心力衰竭进展早期、在出现低钠血症或低血压或需要进行频繁的住院治疗之前就被安排到MCS装置植入中心接受治疗。   她指出,目前的主要心脏衰竭指南,对机械循环

AHA 2013:冠状动脉斑块钙化密度与心血管事件风险呈显著负相关

2013年11月18日,德克萨斯州达拉斯AHA2013年会消息,美国加利福尼亚大学Michael H.Criqui博士带领的研究团队开展的研究表明,冠状动脉钙化体积为冠心病事件和心血管事件风险的独立正相关预测因素;冠状动脉钙化密度与冠心病事件和心血管事件风险呈现显著负相关,且与冠状动脉钙化体积大小无关。对于冠状动脉钙化(CAC),使用计算机断层扫描(CT)评估,对于心血管事件(CVD)发