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BMJ：药物洗脱支架及经皮冠状动脉介入治疗患者术后应选择短期双抗血小板治疗

2019-07-01 MedSci MedSci原创

双抗血小板治疗PCIDES
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与短期DAPT相比，长期DAPT导致严重出血和非心脏性死亡的发生率更高，标准期DAPT与任何出血的风险增加相关。对于ACS患者，短期与标准期DAPT具有相似的疗效和安全性。对于植入新一代DES的患者，长期DAPT导致的全因死亡率高于短期DAPT。研究认为大多数患者在PCI和DES后可考虑短期DAPT

近日研究人员评价了药物洗脱支架(DES)经皮冠状动脉介入治疗(PCI)后标准期(12个月)、长期(>12个月)双抗血小板治疗(DAPT)与短期(<6个月)DAPT的疗效和安全性差异。

本次研究为系统回顾和网络荟萃分析，考察1983-2018年间数据，研究的主要终点是心脏或非心脏死亡，所有原因死亡，心肌梗死，支架血栓形成以及所有出血事件。

总计17项研究（n=46864）。与短期DAPT相比，网络荟萃分析显示，长期DAPT导致大出血（比值比1.78，）和非心源性死亡（1.63）风险增加，标准期DAPT与全因出血风险相关（1.39）。其他主要终点未观察到明显差异。敏感性分析显示，与短期或标准期DAPT相比，在DAPT的18个月内，非心脏性死亡和出血的风险进一步增加。在亚组分析中，长期DAPT导致在植入新一代DES（1.99）的患者中的所有原因死亡率高于短期DAPT，短期DAPT在急性冠脉综合征（ACS）表现和新一代DES后标准期DAPT的疗效和安全性相似。

与短期DAPT相比，长期DAPT导致严重出血和非心脏性死亡的发生率更高，标准期DAPT与任何出血的风险增加相关。对于ACS患者，短期与标准期DAPT具有相似的疗效和安全性。对于植入新一代DES的患者，长期DAPT导致的全因死亡率高于短期DAPT。研究认为大多数患者在PCI和DES后可考虑短期DAPT。

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    2019-10-23 3631181

    #冠状动脉介入治疗#

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    2020-02-22 zhixianchen

    #洗脱支架#

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    2020-06-05 gaoxiaoe

    #BMJ#

    0

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    2019-07-03 lqrandywkz

    #药物洗脱支架#

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=1648950, encodeId=174e164895002, content=<a href='/topic/show?id=6e0630843d0' target=_blank style='color:#2F92EE;'>#冠状动脉介入治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30843, encryptionId=6e0630843d0, topicName=冠状动脉介入治疗)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a9ec23698107, createdName=3631181, createdTime=Wed Oct 23 23:44:00 CST 2019, time=2019-10-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1998775, encodeId=86561998e7544, content=<a href='/topic/show?id=80936510423' target=_blank style='color:#2F92EE;'>#洗脱支架#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65104, encryptionId=80936510423, topicName=洗脱支架)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1e72268, createdName=zhixianchen, createdTime=Sat Feb 22 22:44:00 CST 2020, time=2020-02-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1848777, encodeId=48b11848e7799, content=<a href='/topic/show?id=2977356edc' target=_blank style='color:#2F92EE;'>#BMJ#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3567, encryptionId=2977356edc, topicName=BMJ)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=148754, createdName=gaoxiaoe, createdTime=Fri Jun 05 23:44:00 CST 2020, time=2020-06-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1310503, encodeId=d9151310503fe, content=<a href='/topic/show?id=f70e8e78941' target=_blank style='color:#2F92EE;'>#药物洗脱支架#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=87789, encryptionId=f70e8e78941, topicName=药物洗脱支架)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=86b7385, createdName=lqrandywkz, createdTime=Wed Jul 03 11:44:00 CST 2019, time=2019-07-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1320760, encodeId=25111320e60da, content=<a href='/topic/show?id=cd29e838938' target=_blank style='color:#2F92EE;'>#经皮冠状动脉介入治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78389, encryptionId=cd29e838938, topicName=经皮冠状动脉介入治疗)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ec19483, createdName=aids213, createdTime=Wed Jul 03 11:44:00 CST 2019, time=2019-07-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1487243, encodeId=bcd8148e24399, content=<a href='/topic/show?id=334b3e46139' target=_blank style='color:#2F92EE;'>#双抗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37461, encryptionId=334b3e46139, topicName=双抗)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=bbaa8296156, createdName=yeye5224615, createdTime=Wed Jul 03 11:44:00 CST 2019, time=2019-07-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=368785, encodeId=a737368e85c6, content=学习了，谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7c592194322, createdName=1209e435m98(暂无昵称), createdTime=Mon Jul 01 20:50:52 CST 2019, time=2019-07-01, status=1, ipAttribution=)]
    2019-07-03 aids213

    #经皮冠状动脉介入治疗#

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1648950, encodeId=174e164895002, content=<a href='/topic/show?id=6e0630843d0' target=_blank style='color:#2F92EE;'>#冠状动脉介入治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30843, encryptionId=6e0630843d0, topicName=冠状动脉介入治疗)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a9ec23698107, createdName=3631181, createdTime=Wed Oct 23 23:44:00 CST 2019, time=2019-10-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1998775, encodeId=86561998e7544, content=<a href='/topic/show?id=80936510423' target=_blank style='color:#2F92EE;'>#洗脱支架#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65104, encryptionId=80936510423, topicName=洗脱支架)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1e72268, createdName=zhixianchen, createdTime=Sat Feb 22 22:44:00 CST 2020, time=2020-02-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1848777, encodeId=48b11848e7799, content=<a href='/topic/show?id=2977356edc' target=_blank style='color:#2F92EE;'>#BMJ#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3567, encryptionId=2977356edc, topicName=BMJ)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=148754, createdName=gaoxiaoe, createdTime=Fri Jun 05 23:44:00 CST 2020, time=2020-06-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1310503, encodeId=d9151310503fe, content=<a href='/topic/show?id=f70e8e78941' target=_blank style='color:#2F92EE;'>#药物洗脱支架#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=87789, encryptionId=f70e8e78941, topicName=药物洗脱支架)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=86b7385, createdName=lqrandywkz, createdTime=Wed Jul 03 11:44:00 CST 2019, time=2019-07-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1320760, encodeId=25111320e60da, content=<a href='/topic/show?id=cd29e838938' target=_blank style='color:#2F92EE;'>#经皮冠状动脉介入治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78389, encryptionId=cd29e838938, topicName=经皮冠状动脉介入治疗)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ec19483, createdName=aids213, createdTime=Wed Jul 03 11:44:00 CST 2019, time=2019-07-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1487243, encodeId=bcd8148e24399, content=<a href='/topic/show?id=334b3e46139' target=_blank style='color:#2F92EE;'>#双抗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37461, encryptionId=334b3e46139, topicName=双抗)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=bbaa8296156, createdName=yeye5224615, createdTime=Wed Jul 03 11:44:00 CST 2019, time=2019-07-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=368785, encodeId=a737368e85c6, content=学习了，谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7c592194322, createdName=1209e435m98(暂无昵称), createdTime=Mon Jul 01 20:50:52 CST 2019, time=2019-07-01, status=1, ipAttribution=)]
    2019-07-03 yeye5224615

    #双抗#

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=1648950, encodeId=174e164895002, content=<a href='/topic/show?id=6e0630843d0' target=_blank style='color:#2F92EE;'>#冠状动脉介入治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30843, encryptionId=6e0630843d0, topicName=冠状动脉介入治疗)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a9ec23698107, createdName=3631181, createdTime=Wed Oct 23 23:44:00 CST 2019, time=2019-10-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1998775, encodeId=86561998e7544, content=<a href='/topic/show?id=80936510423' target=_blank style='color:#2F92EE;'>#洗脱支架#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65104, encryptionId=80936510423, topicName=洗脱支架)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1e72268, createdName=zhixianchen, createdTime=Sat Feb 22 22:44:00 CST 2020, time=2020-02-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1848777, encodeId=48b11848e7799, content=<a href='/topic/show?id=2977356edc' target=_blank style='color:#2F92EE;'>#BMJ#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3567, encryptionId=2977356edc, topicName=BMJ)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=148754, createdName=gaoxiaoe, createdTime=Fri Jun 05 23:44:00 CST 2020, time=2020-06-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1310503, encodeId=d9151310503fe, content=<a href='/topic/show?id=f70e8e78941' target=_blank style='color:#2F92EE;'>#药物洗脱支架#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=87789, encryptionId=f70e8e78941, topicName=药物洗脱支架)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=86b7385, createdName=lqrandywkz, createdTime=Wed Jul 03 11:44:00 CST 2019, time=2019-07-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1320760, encodeId=25111320e60da, content=<a href='/topic/show?id=cd29e838938' target=_blank style='color:#2F92EE;'>#经皮冠状动脉介入治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78389, encryptionId=cd29e838938, topicName=经皮冠状动脉介入治疗)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ec19483, createdName=aids213, createdTime=Wed Jul 03 11:44:00 CST 2019, time=2019-07-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1487243, encodeId=bcd8148e24399, content=<a href='/topic/show?id=334b3e46139' target=_blank style='color:#2F92EE;'>#双抗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37461, encryptionId=334b3e46139, topicName=双抗)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=bbaa8296156, createdName=yeye5224615, createdTime=Wed Jul 03 11:44:00 CST 2019, time=2019-07-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=368785, encodeId=a737368e85c6, content=学习了，谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7c592194322, createdName=1209e435m98(暂无昵称), createdTime=Mon Jul 01 20:50:52 CST 2019, time=2019-07-01, status=1, ipAttribution=)]
    2019-07-01 1209e435m98(暂无昵称)

    学习了，谢谢分享

    0

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