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EUR HEART J-CARD PHA：P2Y12抑制剂在急性冠脉综合征合并肾功能不全患者中的应用如何？

2020-02-06 MedSci MedSci原创

肾功能不全患者P2Y12抑制剂
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本研究的目的是建立普拉格雷和替卡格雷在急性冠脉综合征(ACS)肾病患者中的安全性和有效性。

本研究的目的是建立普拉格雷和替卡格雷在急性冠脉综合征(ACS)肾病患者中的安全性和有效性。

研究人员对所有来自RENAMI(心肌梗死患者新抗血小板登记)和BLEEMACS(急性冠脉综合征诊断出院患者多中心登记中的出血并发症)登记的患者按照肾小球滤过率(eGFR)估计低于或大于60 mL/min/1.73 m2进行分层。主要疗效终点是死亡和心肌梗死(MI)。主要出血(MBs)定义为出血学术研究协会出血类型3至5的大出血（MBs）。本研究共纳入19 255例患者，平均年龄63±12岁;男性14 892(77.3%)。慢性肾病定义为eGFR <60 mL/min/1.73 m2有2490例(12.9%)。平均随访时间为13±5个月。CKD患者的死亡率明显升高(9.4% vs. 2.6%， P < 0.0001)，再梗死发生率(5.8% vs. 2.9%， P < 0.0001)和MB (5.7% vs. 3%， P < 0.0001)。在Cox多变量分析中，与氯吡格雷比较，有效的P2Y12抑制剂可显着降低慢性肾病患者的死亡率[危险比（HR）0.82，95％置信区间（CI）0.54–0.96；以及CKD患者发生再梗塞的风险（HR = 0.53，95％CI 0.30-0.95； P = 0.033）（P = 0.006）。

研究表明，在ACS慢性肾病患者中，普拉格雷和替卡格雷与较低的死亡和复发性心肌梗死风险相关，而不会增加MB的风险。

原始出处：

Ovidio De Filippo，Fabrizio D’Ascenzo,P2Y12 inhibitors in acute coronary syndrome patients with renal dysfunction: an analysis from the RENAMI and BleeMACS projects

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    2020-11-02 jklm09

    #抑制剂#

    0

  2. 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    2020-06-01 yeye5224612

    #P2Y12#

    0

  3. 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    2020-05-19 liuquan

    #2抑制剂#

    0

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encryptionId=46c682469e4, topicName=肾功能)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=28d456, createdName=yese, createdTime=Mon Mar 23 21:14:00 CST 2020, time=2020-03-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1285034, encodeId=abc412850344c, content=<a href='/topic/show?id=db45824e11f' target=_blank style='color:#2F92EE;'>#肾功能不全#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=82471, encryptionId=db45824e11f, topicName=肾功能不全)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b79433, createdName=jiangjun073, createdTime=Sat Feb 08 08:14:00 CST 2020, time=2020-02-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1357389, encodeId=50d4135e389af, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Sat Feb 08 08:14:00 CST 2020, time=2020-02-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1431753, encodeId=df1f1431e53ce, 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=22, 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=Sat Feb 08 08:14:00 CST 2020, time=2020-02-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1442731, encodeId=eccb1442e3185, content=<a href='/topic/show?id=687313616b4' target=_blank style='color:#2F92EE;'>#P2Y12抑制剂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13616, encryptionId=687313616b4, topicName=P2Y12抑制剂)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ff014972968, createdName=luckyshitiancai_42705685, createdTime=Sat Feb 08 08:14:00 CST 2020, time=2020-02-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1563222, encodeId=a909156322264, content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=80d715270048, createdName=slcumt, createdTime=Sat Feb 08 08:14:00 CST 2020, time=2020-02-08, status=1, ipAttribution=)]
    2020-03-23 yese

    #肾功能#

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=1852264, encodeId=07a71852264c1, content=<a href='/topic/show?id=f0a254918f0' target=_blank style='color:#2F92EE;'>#抑制剂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=18, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54918, encryptionId=f0a254918f0, topicName=抑制剂)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=44a360, createdName=jklm09, createdTime=Mon Nov 02 19:14:00 CST 2020, time=2020-11-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1940221, encodeId=a70a1940221f6, content=<a href='/topic/show?id=18f81361276' target=_blank style='color:#2F92EE;'>#P2Y12#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13612, encryptionId=18f81361276, topicName=P2Y12)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a12645, 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encryptionId=46c682469e4, topicName=肾功能)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=28d456, createdName=yese, createdTime=Mon Mar 23 21:14:00 CST 2020, time=2020-03-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1285034, encodeId=abc412850344c, content=<a href='/topic/show?id=db45824e11f' target=_blank style='color:#2F92EE;'>#肾功能不全#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=82471, encryptionId=db45824e11f, topicName=肾功能不全)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b79433, createdName=jiangjun073, createdTime=Sat Feb 08 08:14:00 CST 2020, time=2020-02-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1357389, encodeId=50d4135e389af, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Sat Feb 08 08:14:00 CST 2020, time=2020-02-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1431753, encodeId=df1f1431e53ce, 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=22, 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=Sat Feb 08 08:14:00 CST 2020, time=2020-02-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1442731, encodeId=eccb1442e3185, content=<a href='/topic/show?id=687313616b4' target=_blank style='color:#2F92EE;'>#P2Y12抑制剂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13616, encryptionId=687313616b4, topicName=P2Y12抑制剂)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ff014972968, createdName=luckyshitiancai_42705685, createdTime=Sat Feb 08 08:14:00 CST 2020, time=2020-02-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1563222, encodeId=a909156322264, content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=80d715270048, createdName=slcumt, createdTime=Sat Feb 08 08:14:00 CST 2020, time=2020-02-08, status=1, ipAttribution=)]
    2020-02-08 jiangjun073

    #肾功能不全#

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1852264, encodeId=07a71852264c1, content=<a href='/topic/show?id=f0a254918f0' target=_blank style='color:#2F92EE;'>#抑制剂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=18, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54918, encryptionId=f0a254918f0, topicName=抑制剂)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=44a360, createdName=jklm09, createdTime=Mon Nov 02 19:14:00 CST 2020, time=2020-11-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1940221, encodeId=a70a1940221f6, content=<a href='/topic/show?id=18f81361276' target=_blank style='color:#2F92EE;'>#P2Y12#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13612, encryptionId=18f81361276, topicName=P2Y12)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a12645, 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encryptionId=46c682469e4, topicName=肾功能)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=28d456, createdName=yese, createdTime=Mon Mar 23 21:14:00 CST 2020, time=2020-03-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1285034, encodeId=abc412850344c, content=<a href='/topic/show?id=db45824e11f' target=_blank style='color:#2F92EE;'>#肾功能不全#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=82471, encryptionId=db45824e11f, topicName=肾功能不全)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b79433, createdName=jiangjun073, createdTime=Sat Feb 08 08:14:00 CST 2020, time=2020-02-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1357389, encodeId=50d4135e389af, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Sat Feb 08 08:14:00 CST 2020, time=2020-02-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1431753, encodeId=df1f1431e53ce, 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=22, 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=Sat Feb 08 08:14:00 CST 2020, time=2020-02-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1442731, encodeId=eccb1442e3185, content=<a href='/topic/show?id=687313616b4' target=_blank style='color:#2F92EE;'>#P2Y12抑制剂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13616, encryptionId=687313616b4, topicName=P2Y12抑制剂)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ff014972968, createdName=luckyshitiancai_42705685, createdTime=Sat Feb 08 08:14:00 CST 2020, time=2020-02-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1563222, encodeId=a909156322264, content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=80d715270048, createdName=slcumt, createdTime=Sat Feb 08 08:14:00 CST 2020, time=2020-02-08, status=1, ipAttribution=)]
    2020-02-08 zhaojie88

    #ART#

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=1852264, encodeId=07a71852264c1, content=<a href='/topic/show?id=f0a254918f0' target=_blank style='color:#2F92EE;'>#抑制剂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=18, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54918, encryptionId=f0a254918f0, topicName=抑制剂)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=44a360, createdName=jklm09, createdTime=Mon Nov 02 19:14:00 CST 2020, time=2020-11-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1940221, encodeId=a70a1940221f6, content=<a href='/topic/show?id=18f81361276' target=_blank style='color:#2F92EE;'>#P2Y12#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13612, encryptionId=18f81361276, topicName=P2Y12)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a12645, createdName=yeye5224612, createdTime=Mon Jun 01 14:14:00 CST 2020, time=2020-06-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1995586, encodeId=c5031995586e5, content=<a href='/topic/show?id=992411149e' target=_blank style='color:#2F92EE;'>#2抑制剂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1114, encryptionId=992411149e, topicName=2抑制剂)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=28b7142, createdName=liuquan, createdTime=Tue May 19 16:14:00 CST 2020, time=2020-05-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1850734, encodeId=4dda1850e34a6, content=<a href='/topic/show?id=46c682469e4' target=_blank style='color:#2F92EE;'>#肾功能#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=82469, encryptionId=46c682469e4, topicName=肾功能)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=28d456, createdName=yese, createdTime=Mon Mar 23 21:14:00 CST 2020, time=2020-03-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1285034, encodeId=abc412850344c, content=<a href='/topic/show?id=db45824e11f' target=_blank style='color:#2F92EE;'>#肾功能不全#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=82471, encryptionId=db45824e11f, topicName=肾功能不全)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b79433, createdName=jiangjun073, createdTime=Sat Feb 08 08:14:00 CST 2020, time=2020-02-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1357389, encodeId=50d4135e389af, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Sat Feb 08 08:14:00 CST 2020, time=2020-02-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1431753, encodeId=df1f1431e53ce, 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=22, 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=Sat Feb 08 08:14:00 CST 2020, time=2020-02-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1442731, encodeId=eccb1442e3185, content=<a href='/topic/show?id=687313616b4' target=_blank style='color:#2F92EE;'>#P2Y12抑制剂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13616, encryptionId=687313616b4, topicName=P2Y12抑制剂)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ff014972968, createdName=luckyshitiancai_42705685, createdTime=Sat Feb 08 08:14:00 CST 2020, time=2020-02-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1563222, encodeId=a909156322264, content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=80d715270048, createdName=slcumt, createdTime=Sat Feb 08 08:14:00 CST 2020, time=2020-02-08, status=1, ipAttribution=)]
    2020-02-08 zhouqu_8

    #综合征#

    0

  8. 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    2020-02-08 luckyshitiancai_42705685

    #P2Y12抑制剂#

    0

  9. 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authenticateStatus=null, createdAvatar=null, createdBy=80d715270048, createdName=slcumt, createdTime=Sat Feb 08 08:14:00 CST 2020, time=2020-02-08, status=1, ipAttribution=)]
    2020-02-08 slcumt

    #HEART#

    0

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