Int J Cardiol:主动脉瓣狭窄患者心肌梗死后双重抗血小板治疗的相关结果

2019-01-20 xing.T MedSci原创

由此可见,当采用DAPT治疗时,AS与MI后出血、复发性心肌梗死和死亡率风险增加有关。在这个高危人群中,可能需要个体化选择抗血小板治疗。

获得性最大血管性血友病因子多聚体的丢失是主动脉瓣狭窄(AS)患者常见的止血障碍,导致血小板粘连受损和出血风险增加。AS还与动脉粥样硬化和心肌梗塞(MI)有关。近日,血管领域权威杂志International Journal of Cardiology上发表了一篇研究文章,研究人员的目的是在全国范围的医院登记研究中探究接受双重抗血小板治疗(DAPT)的MI患者与AS相关的临床结局。

以瑞典(2005-2010)和丹麦(2005-2015)的全国医院出院登记中心为基础,研究人员计算了接受DAPT的伴有和不伴有AS的MI患者出血、复发性MI和全因死亡率的1年发病率和风险比。两个国家的结果也合并在一项荟萃分析中。

研究人员收集了来自瑞典的50460名MI患者和来自丹麦的50307名MI患者,其中3%的参与者患有AS。瑞典和丹麦的出血率(每100人每年)在没有AS的患者中分别为3.2和3.3,而在AS患者中分别为9.2和8.3。瑞典伴有和不伴有AS参与者的全因死亡率分别为7.1和28.7,丹麦分别为5.8和30.7。 AS患者出血、复发性心肌梗死和全因死亡风险增加。两国的复合结果相似,对于出血(风险比为1.59 [0.98-2.59])、复发MI(1.78 [1.25-2.54])和全因死亡率(1.76 [1.26-2.47])。

由此可见,当采用DAPT治疗时,AS与MI后出血、复发性心肌梗死和死亡率风险增加有关。在这个高危人群中,可能需要个体化选择抗血小板治疗。

原始出处:

AndreasMartinsson,et al.Outcomes associated with dual antiplatelet therapy after myocardial infarction in patients with aortic stenosis.International Journal of Cardiology.2019.https://doi.org/10.1016/j.ijcard.2019.01.063

本文系梅斯医学(MedSci)原创编译整理,转载需授权!

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 (4)
#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=1781997, encodeId=5c351e8199766, content=<a href='/topic/show?id=5db8409ed8' target=_blank style='color:#2F92EE;'>#Cardiol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4097, encryptionId=5db8409ed8, topicName=Cardiol)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8e886, createdName=仁者大医, createdTime=Sat Jun 08 11:19:00 CST 2019, time=2019-06-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1332611, encodeId=c4bd133261175, content=<a href='/topic/show?id=1dd6231822d' target=_blank style='color:#2F92EE;'>#主动脉瓣#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23182, encryptionId=1dd6231822d, topicName=主动脉瓣)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=dc4b2500077, createdName=hittouch, createdTime=Tue Jan 22 03:19:00 CST 2019, time=2019-01-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1402176, encodeId=7a8914021e663, content=<a href='/topic/show?id=26163e63362' target=_blank style='color:#2F92EE;'>#双重抗血小板治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37633, encryptionId=26163e63362, topicName=双重抗血小板治疗)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTL6ka7cRR8xsokbAYjhg0mZeBm79vHeyXiaMibkYndHaibgmfg1JDA0AXlGaY8Og4IiaREUFYuBwekPoQ/132, createdBy=19852392148, createdName=bioon4, createdTime=Tue Jan 22 03:19:00 CST 2019, time=2019-01-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1415452, encodeId=5a38141545232, content=<a href='/topic/show?id=04812314540' target=_blank style='color:#2F92EE;'>#主动脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23145, encryptionId=04812314540, topicName=主动脉)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=77603112682, createdName=circumcision, createdTime=Tue Jan 22 03:19:00 CST 2019, time=2019-01-22, status=1, ipAttribution=)]
  2. [GetPortalCommentsPageByObjectIdResponse(id=1781997, encodeId=5c351e8199766, content=<a href='/topic/show?id=5db8409ed8' target=_blank style='color:#2F92EE;'>#Cardiol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4097, encryptionId=5db8409ed8, topicName=Cardiol)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8e886, createdName=仁者大医, createdTime=Sat Jun 08 11:19:00 CST 2019, time=2019-06-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1332611, encodeId=c4bd133261175, content=<a href='/topic/show?id=1dd6231822d' target=_blank style='color:#2F92EE;'>#主动脉瓣#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23182, encryptionId=1dd6231822d, topicName=主动脉瓣)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=dc4b2500077, createdName=hittouch, createdTime=Tue Jan 22 03:19:00 CST 2019, time=2019-01-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1402176, encodeId=7a8914021e663, content=<a href='/topic/show?id=26163e63362' target=_blank style='color:#2F92EE;'>#双重抗血小板治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37633, encryptionId=26163e63362, topicName=双重抗血小板治疗)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTL6ka7cRR8xsokbAYjhg0mZeBm79vHeyXiaMibkYndHaibgmfg1JDA0AXlGaY8Og4IiaREUFYuBwekPoQ/132, createdBy=19852392148, createdName=bioon4, createdTime=Tue Jan 22 03:19:00 CST 2019, time=2019-01-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1415452, encodeId=5a38141545232, content=<a href='/topic/show?id=04812314540' target=_blank style='color:#2F92EE;'>#主动脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23145, encryptionId=04812314540, topicName=主动脉)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=77603112682, createdName=circumcision, createdTime=Tue Jan 22 03:19:00 CST 2019, time=2019-01-22, status=1, ipAttribution=)]
  3. [GetPortalCommentsPageByObjectIdResponse(id=1781997, encodeId=5c351e8199766, content=<a href='/topic/show?id=5db8409ed8' target=_blank style='color:#2F92EE;'>#Cardiol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4097, encryptionId=5db8409ed8, topicName=Cardiol)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8e886, createdName=仁者大医, createdTime=Sat Jun 08 11:19:00 CST 2019, time=2019-06-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1332611, encodeId=c4bd133261175, content=<a href='/topic/show?id=1dd6231822d' target=_blank style='color:#2F92EE;'>#主动脉瓣#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23182, encryptionId=1dd6231822d, topicName=主动脉瓣)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=dc4b2500077, createdName=hittouch, createdTime=Tue Jan 22 03:19:00 CST 2019, time=2019-01-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1402176, encodeId=7a8914021e663, content=<a href='/topic/show?id=26163e63362' target=_blank style='color:#2F92EE;'>#双重抗血小板治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37633, encryptionId=26163e63362, topicName=双重抗血小板治疗)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTL6ka7cRR8xsokbAYjhg0mZeBm79vHeyXiaMibkYndHaibgmfg1JDA0AXlGaY8Og4IiaREUFYuBwekPoQ/132, createdBy=19852392148, createdName=bioon4, createdTime=Tue Jan 22 03:19:00 CST 2019, time=2019-01-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1415452, encodeId=5a38141545232, content=<a href='/topic/show?id=04812314540' target=_blank style='color:#2F92EE;'>#主动脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23145, encryptionId=04812314540, topicName=主动脉)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=77603112682, createdName=circumcision, createdTime=Tue Jan 22 03:19:00 CST 2019, time=2019-01-22, status=1, ipAttribution=)]
  4. [GetPortalCommentsPageByObjectIdResponse(id=1781997, encodeId=5c351e8199766, content=<a href='/topic/show?id=5db8409ed8' target=_blank style='color:#2F92EE;'>#Cardiol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4097, encryptionId=5db8409ed8, topicName=Cardiol)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8e886, createdName=仁者大医, createdTime=Sat Jun 08 11:19:00 CST 2019, time=2019-06-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1332611, encodeId=c4bd133261175, content=<a href='/topic/show?id=1dd6231822d' target=_blank style='color:#2F92EE;'>#主动脉瓣#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23182, encryptionId=1dd6231822d, topicName=主动脉瓣)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=dc4b2500077, createdName=hittouch, createdTime=Tue Jan 22 03:19:00 CST 2019, time=2019-01-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1402176, encodeId=7a8914021e663, content=<a href='/topic/show?id=26163e63362' target=_blank style='color:#2F92EE;'>#双重抗血小板治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37633, encryptionId=26163e63362, topicName=双重抗血小板治疗)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTL6ka7cRR8xsokbAYjhg0mZeBm79vHeyXiaMibkYndHaibgmfg1JDA0AXlGaY8Og4IiaREUFYuBwekPoQ/132, createdBy=19852392148, createdName=bioon4, createdTime=Tue Jan 22 03:19:00 CST 2019, time=2019-01-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1415452, encodeId=5a38141545232, content=<a href='/topic/show?id=04812314540' target=_blank style='color:#2F92EE;'>#主动脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23145, encryptionId=04812314540, topicName=主动脉)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=77603112682, createdName=circumcision, createdTime=Tue Jan 22 03:19:00 CST 2019, time=2019-01-22, status=1, ipAttribution=)]

相关资讯

JACC:常规临床实践中可重新定位且可完全取回主动脉瓣的应用

RESPOND研究的1年结局证实了Lotus瓣膜用于常规临床实践的安全性和有效性。

Circ: Cardiovasc Inte:经导管主动脉瓣置换术后左心室心肌功能的预后相关因素

左心室心肌做功指数Tei与经导管主动脉瓣置换术后长短期随访期间的临床结局受损有关。

Circ: Cardiovasc Inte:根据手术风险一个欧洲经导管主动脉瓣植入队列的1年结局

在临床实践中,三分之二使用SAPIEN 3经导管心脏瓣膜治疗的经导管主动脉瓣植入患者logES<20,但仍被心脏治疗团队认为适合进行经导管主动脉瓣植入,主要是因为年龄较大。

JAHA:动脉特性作为严重主动脉瓣狭窄左心室质量和纤维化的决定因素

与动物研究一致,动脉波反射与严重主动脉瓣狭窄患者的间隙容量扩大相关,并可以预测AVR后较小的生活质量改善。

JACC:经导管主动脉瓣置换术后血小板反应性的评估

在很多接受TAVR治疗的AS患者中存在针对氯吡格雷的HPR。

JACC:严重主动脉瓣狭窄的肿瘤患者进行的经导管主动脉瓣置换术

与无癌症患者相比,癌症患者的TAVR与相似的短期预后和较差的长期预后相关。