JAMA:PCI后1个月强化双抗血小板治疗的效果优于传统12个月疗法

2019-06-26 MedSci MedSci原创

研究认为,对于PCI患者,术后接受1个月的超短期强化双抗血小板治疗相比于传统12个月疗法,在降低心血管事件及出血风险方面更具优势

超短期强化双抗血小板治疗(DAPT)是经皮冠状动脉介入药物洗脱支架治疗(PCI)后的选择之一,近日研究人员比较了1个月DAPT与标准12个月DAPT对患者心血管事件和出血风险的影响。

研究在日本开展, PCI患者随机在氯吡格雷单药治疗后接受1个月 (1523例)或12个月的阿司匹林+氯吡格雷治疗 (1522例)。研究的主要终点是心血管死亡、心肌梗死(MI)、缺血性或出血性卒中、明确的支架血栓形成或12个月时大小出血的复合终点。主要继发性心血管终点包括心血管死亡、心肌梗死、缺血性或出血性卒中或明确的支架血栓形成的复合终点,主要继发性出血终点是大出血或小出血。

2974人(99%)完成了试验。研究发现,1个月DAPT治疗在主要终点方面优于12个月DAPT治疗,主要终点发生率,1个月组为2.36%,12个月为3.70%(绝对值:-1.34%;危险比0.64)。主要次级心血管终点分别为1.96%和2.51%(绝对差,-0.55%;HR 0.79)。主要继发出血终点分别为0.41%和1.54%(绝对差:-1.13%;HR 0.26)。

研究认为,对于PCI患者,术后接受1个月的超短期强化双抗血小板治疗相比于传统12个月疗法,在降低心血管事件及出血风险方面更具优势。

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    2019-06-27 yjs木玉

    好好好好好好

    0

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    2019-06-26 CHANGE

    疗效只是效果的众多方面之一,还要看对患者的获益,包括生活质量等因素共同决定效果的

    0

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    2019-06-26 天地飞扬

    学习

    0

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    2019-06-26 1381f06c43m

    学习了

    0

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    2019-06-26 1209e435m98(暂无昵称)

    学习了,谢谢分享

    0

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JCLA:应用药物洗脱支架经皮冠状动脉介入治疗冠心病患者快速血管造影狭窄进展和再狭窄风险的预测因素的综合分析

本研究旨在探讨经皮冠状动脉介入治疗(PCI)合并药物洗脱支架植入术后冠状动脉疾病(CAD)患者发生快速血管造影狭窄进展(RASP)和再狭窄的风险与基线、程序和术后特点的相关性。 本研究连续登记接受PCI治疗并植入药物洗脱支架214例冠心病患者。收集患者的基线、程序和术后特征进行分析。冠状动脉造影评估PCI术前和PCI术后12个月的冠状动脉狭窄情况。然后评估非靶病变的RASP和支架植入靶病变的

JAMA:P2Y12抑制剂单药治疗对PCI患者心血管事件的影响研究

研究发现,在接受经皮冠状动脉介入治疗的患者中,与延长DAPT方案相比,单用P2Y12抑制剂治疗3个月后患者主要不良心脑血管事件发生率无显著差异

Lancet:植入后第一年新一代药物洗脱支架的安全性优于金属支架

总体上植入后第一年的新一代DES的性能优于BMS

病例精选:OCT指导下冠状动脉分叉病变的PCI治疗一例

患者为一名75岁男性患者,入院前2月反复于静息状态下出现心前区胀痛,每次持续数分钟可自行缓解,自觉症状与活动及情绪激动无明显关系。既往有20余年高血压病史,不吸烟,无冠心病家族史。