JACC:DES置入后DAPT患者临床出血率及支架血栓率分析

2015-04-07 徐媛媛译 MedSci原创

药物洗脱支架(DES)植入后双重抗血小板治疗的最佳时间(DAPT)尚不清楚。根据DES植入代数确定其风险和收益可能有所不同。 本研究的目的是对DAPT患者置入DES后的疗效和安全性进行评估。我们收纳了随机对照试验,评估对DES置入后DAPT治疗的最佳时间。短期双重抗血小板治疗(S-DAPT)被定义为按实验方案最短DAPT时期,长期双重抗血小板治疗(L-DAPT)被定义为按实验方案最长DAPT时期

药物洗脱支架(DES)植入后双重抗血小板治疗的最佳时间(DAPT)尚不清楚。根据DES植入代数确定其风险和收益可能有所不同。

本研究的目的是对DAPT患者置入DES后的疗效和安全性进行评估。我们收纳了随机对照试验,评估对DES置入后DAPT治疗的最佳时间。短期双重抗血小板治疗(S-DAPT)被定义为按实验方案最短DAPT时期,长期双重抗血小板治疗(L-DAPT)被定义为按实验方案最长DAPT时期。这些试验对DES置入后DAPT患者的临床明显出血率及支架血栓率进行了比较。

我们收纳了10项随机对照试验(DAPT患者(n=32135))进行荟萃分析。结果显示,与长期DAPT相比,短期DAPT患支架血栓率增加(OR = 1.71;95% CI,1.26-2.32),但二代DES(OR = 1.54;95% CI,0.96-2.47)置入患者的支架血栓率低于一代DES(OR = 3.94;95% CI,2.2-7.05;P = .008)置入患者。而且,短期DAPT与临床明显出血率(OR = 0.63;95% CI,0.52-0.75)及全因死亡率(OR = 0.87;95% CI,0.74-1.01)较低有关。

研究结果表明,与长期DAPT相比,短期DAPT患支架血栓率增加,出血率降低。二代DES可降低长期DAPT获益,但总体数据显示该类支架使晚期支架血栓风险大幅降低,虽然它会减小各类DES血栓相对风险降低量。长期DAPT全因死亡率没有达到统计学意义。

原始出处

Giustino G1, Baber U1, Sartori S1, Mehran R1, Mastoris I1, Kini AS1, Sharma SK1, Pocock SJ2, Dangas GD3.Duration of Dual Antiplatelet Therapy After Drug-Eluting Stent Implantation: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.J Am Coll Cardiol. 2015 Apr 7

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    2016-01-20 hbwxf
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    2015-04-11 x35042875

    必须要接受教育、认可理念

    0

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    2015-04-09 mnda
  5. [GetPortalCommentsPageByObjectIdResponse(id=1853332, encodeId=533b185333280, content=<a href='/topic/show?id=48351020537' target=_blank style='color:#2F92EE;'>#JACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10205, encryptionId=48351020537, topicName=JACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=55ce62, createdName=hbwxf, createdTime=Wed Jan 20 10:09:00 CST 2016, time=2016-01-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=20216, encodeId=0fca202160a, content=必须要接受教育、认可理念, beContent=null, objectType=article, channel=null, level=null, likeNumber=104, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20150920/IMG55FDE671A89482379.jpg, createdBy=cef3108336, createdName=x35042875, createdTime=Sat Apr 11 18:38:00 CST 2015, time=2015-04-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1325020, encodeId=ce8f1325020f6, content=<a href='/topic/show?id=96c71804b7' target=_blank style='color:#2F92EE;'>#ACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1804, encryptionId=96c71804b7, topicName=ACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1e452500029, createdName=12498568m50暂无昵称, createdTime=Thu Apr 09 06:09:00 CST 2015, time=2015-04-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1374334, encodeId=cb0613e433427, content=<a href='/topic/show?id=6d5d56912e' target=_blank style='color:#2F92EE;'>#DAPT#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5691, encryptionId=6d5d56912e, topicName=DAPT)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6a8d381, createdName=mnda, createdTime=Thu Apr 09 06:09:00 CST 2015, time=2015-04-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1558494, encodeId=4fe91558494f2, content=<a href='/topic/show?id=b68a586365' target=_blank style='color:#2F92EE;'>#DES#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5863, encryptionId=b68a586365, topicName=DES)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=432c14994935, createdName=fusion, createdTime=Thu Apr 09 06:09:00 CST 2015, time=2015-04-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1564503, encodeId=ba9e156450347, content=<a href='/topic/show?id=b68a586365' target=_blank style='color:#2F92EE;'>#DES#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5863, encryptionId=b68a586365, topicName=DES)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=432c14994935, createdName=fusion, createdTime=Thu Apr 09 06:09:00 CST 2015, time=2015-04-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1582564, encodeId=0109158256465, content=<a href='/topic/show?id=c1695e118ac' target=_blank style='color:#2F92EE;'>#支架血栓#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=57118, encryptionId=c1695e118ac, topicName=支架血栓)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b83016955660, createdName=ms1779634646866130, createdTime=Thu Apr 09 06:09:00 CST 2015, time=2015-04-09, status=1, ipAttribution=)]
    2015-04-09 fusion
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    2015-04-09 fusion
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