Heart:β受体阻滞剂在经皮冠状动脉介入治疗急性冠脉综合征患者中的作用

2020-09-05 MedSci原创 MedSci原创

BB的使用率仍然很高,并且与降低死亡率有关。死亡率的降低主要见于射血分数降低的患者,而射血分数正常的患者死亡率则没有降低。

目前缺乏证据支持在接受经皮冠状动脉介入治疗(PCI)的急性冠脉综合征(ACS)患者中常规使用β受体阻滞剂(BB)。近日,心脏病领域权威杂志Heart上发表了一篇研究文章,这项研究的目的是评估PCI后BB的使用及其与死亡率之间的关系。此外,该研究旨在评估左心室射血分数(LVEF)<35%、LVEF为35%–50%和LVEF>50%的亚组患者使用BB与死亡率之间的关系。

研究人员使用了大型PCI登记中心2005年1月至2017年6月期间存活超过30天的ACS患者数据并进行分析。将30天服用BB的患者与未服用BB的患者进行比较。该研究的主要结局是全因死亡率,受试者平均随访时间为5.3±3.5年。

在17562名受试者中,服用BB的占83.3%。BB组的死亡率较低(13.1% vs. 19.5%,p=0.0001)。多变量Cox比例风险模型发现BB的使用与较低的总死亡率相关(校正后的HR为0.87,95%CI为0.78至0.97,p=0.014)。在亚组分析中,服用BB与LVEF<35%(调整后的HR为0.63、95%CI为0.44-0.91,p=0.013)、LVEF为35%–50%(调整后的HR为0.80、95%CI为0.68-0.95,p=0.01)的患者死亡率降低相关,但与LVEF>50%的患者无关(调整后的HR为1.03,95%CI为0.87-1.21,p=0.74)。

由此可见,BB的使用率仍然很高,并且与降低死亡率有关。死亡率的降低主要见于射血分数降低的患者,而射血分数正常的患者死亡率则没有降低。

原始出处:

Kah Yong Peck.et al.Role of beta blockers following percutaneous coronary intervention for acute coronary syndrome.heart.2020.https://heart.bmj.com/content/early/2020/09/03/heartjnl-2020-316605

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    2021-08-06 zhyy88
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    2020-11-16 qcl1997

    不错

    0

  4. 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  5. 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    2020-09-18 1467061cm21暂无昵称

    有用

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  6. 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  7. 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  8. 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    2020-09-07 zhaojie88
  9. 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    2020-09-07 slcumt

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口服P2Y12抑制剂的新随机对照试验已经在急性冠状动脉综合征中展开。本研究旨在通过随机对照试验的荟萃分析,评估比较普拉格雷、替格瑞洛和氯吡格雷在急性冠脉综合征中的疗效和安全性。

NAT COMMUN:优于临床医生,机器学习助力急性冠脉综合征预测 

目前,迅速识别急性冠脉综合征仍然是临床实践中的一个重要挑战。12导联心电图(ECG)在患者初始评估时很容易获得,但基于当前规则的解释方法缺乏足够的准确性。

Lancet:双重抗血小板疗法“减剂量策略”明显改善急性冠脉综合征患者PCI术后预后

接受经皮冠状动脉介入(PCI)治疗的急性冠脉综合征患者被推荐采用长达一年的基于P2Y12抑制剂的双重抗血小板治疗。这种P2Y12抑制剂的最大收益在用药早期阶段,随着用药时间的延长,大出血的风险会随之增

JAHA:急性冠脉综合征后HIV感染与长期心血管风险之间的关系

尽管PLHIV和HIV未感染者之间发生重大不良心脏和脑血管事件的总体风险在统计学上无显著差异,但PLHIV发生复发性ACS的几率更高。

Int J Cardiol:肾功能不全患者被忽视!中国急性冠脉综合征临床路径项目新分析

在中国急性冠脉综合征患者中,肾功能不全的患者较少接受指南推荐的治疗策略,其临床预后也较差。

Circulation:峰回路转!有效降低双重抗血小板疗法出血风险的新策略

阿司匹林和P2Y12抑制剂的双重抗血小板疗法已被证实可降低PCI或急性冠脉综合征后的MACE风险,但同时会增加出血风险。本研究旨在评估停用阿司匹林而采用P2Y12抑制剂单一疗法的安全性。