JAMA:替卡格雷vs氯吡格雷对PCI后急性冠状动脉综合征患者净不良临床事件风险的影响

2020-10-28 MedSci原创 MedSci原创

对于常规临床实践中接受PCI的ACS患者中,与氯吡格雷相比,接受替卡格雷治疗患者的12个月净不良临床事件风险无显著性差异

目前的指南推荐替卡格雷作为急性冠状动脉综合征(ACS)患者首选的P2Y12血小板抑制剂,近日研究人员比较了替卡格雷与氯吡格雷在临床实践中对接受经皮冠状动脉介入治疗(PCI)的急性冠脉综合征(ACS)患者缺血和出血事件的影响。
 
研究于2011年11月至2019年3月开展,使用2个基于美国电子健康记录的数据库和1个韩国全国数据库数据,对接受PCI并接受替卡格雷或者氯吡格雷治疗的ACS患者进行了回顾性队列研究。研究的主要终点为12个月时的净不良临床事件(NACE),包括缺血性事件(复发性心肌梗死、血运重建或缺血性中风)和出血性事件(出血性中风或胃肠道出血)。次要结果包括NACE或死亡率、全因死亡率、缺血性事件、出血性事件、主要结果的个别组成部分以及12个月时的呼吸困难。
 
总计包含31290对倾向匹配患者,年龄60-64岁;29.3%女性,95.5%的患者在服用阿司匹林基础上,接受氯吡格雷或替卡格雷治疗。替卡格雷和氯吡格雷组1年的NACE风险无显著性差异(15.1%[3484/23116人-年]vs14.6%[3290/22587人-年];总HR:1.05)。全因死亡率(替卡格雷组为2.0% vs 氯吡格雷组为2.1%; 总HR:0.97)或缺血性事件(替卡格雷组为13.5% vs 氯吡格雷组为13.4%; 总HR:1.03)的风险也没有显著差异。替卡格雷组出血性事件(替卡格雷为2.1%  vs 氯吡格雷为1.6%; 总 HR:1.35)和呼吸困难(替卡格雷为27.3% vs 氯吡格雷为22.6%; 总HR: 1.21)的风险升高。
 
对于常规临床实践中接受PCI的ACS患者中,与氯吡格雷相比,接受替卡格雷治疗患者的12个月净不良临床事件风险无显著性差异。
 
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    2020-10-30 咻凡

    目前的指南推荐替卡格雷作为急性冠状动脉综合征(ACS)患者首选的P2Y12血小板抑制剂

    0

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    2020-10-29 Lexi

    对于常规临床实践中接受PCI的ACS患者中,与氯吡格雷相比,接受替卡格雷治疗患者的12个月净不良临床事件风险无显著性差异。

    0

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    2020-10-28 旺医

    顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息

    0

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