Stroke:症状性颈动脉狭窄患者血小板粘附抑制剂Revacept的疗效

2022-06-15 MedSci原创 MedSci原创

症状性颈内动脉(ICA)狭窄患者是缺血性卒中复发的高危人群,120 mg Revacept治疗可降低症状性ICA狭窄患者的联合安全性和有效性终点。

症状性颈内动脉(ICA)狭窄患者是缺血性卒中复发的高危人群,需要早期介入治疗和抗血小板治疗。出血发生率增加可能会抵消围手术期强化血小板抑制的疗效。

近日,心血管疾病领域权威杂志Stroke上发表了一篇研究文章,研究人员的目的是探究糖蛋白VI竞争性拮抗剂-Revacept来辅助标准抗血小板治疗是否能减少症状性ICA狭窄患者缺血性病变的发生几率。

在这项国际、多中心(16个地区)、随机(1:1:1)、双盲、安慰剂对照的平行组研究纳入了有症状的ICA狭窄患者。在符合指南的抗血小板治疗之外,单次输注安慰剂、40mg或120mg Revacept,以评估疗效终点:治疗开始后扩散加权磁共振成像上新的缺血性病变的数量。该研究的主要临床结局为联合安全性和有效性终点,包括随访期间任何卒中或死亡、短暂性脑缺血发作、心肌梗死、冠状动脉介入和出血并发症。

在160名随机患者中,158名患者(68±10.1年,24%为女性)接受了研究药物治疗(51名患者为安慰剂,54名患者为40mg Revacept,53名患者为120mg Revacept),随访11.2±2.3个月,在安慰剂/40mg/120mg Revacept治疗组中每名患者分别有1.16(95%CI为0.88-1.53)/1.05(95%CI为0.78-1.42;P=0.629)/0.63(95%CI为0.43-0.93)处检测到了新发弥散加权磁共振成像病变,且没有统计学上的差异。在研究期间,相比于安慰剂组,在服用120 mg Revacept的患者中观察到了联合安全性和有效性终点降低(HR为0.46[95%CI为0.21-0.99];P=0.047),而在40mg Revacept组中则不然(HR为0.72[95%CI为0.37-1.42];P=0.343)。

由此可见,120 mg Revacept治疗可降低症状性ICA狭窄患者的联合安全性和有效性终点。

原始出处:

Timo Uphaus.et al.Revacept, an Inhibitor of Platelet Adhesion in Symptomatic Carotid Stenosis: A Multicenter Randomized Phase II Trial.stroke.2022.https://www.ahajournals.org/doi/10.1161/STROKEAHA.121.037006

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    2022-12-29 xiaoyeshuang
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    2023-05-23 shanyongle
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    2022-07-21 jklm09
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    2022-07-25 仁医06
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