JACC:接受PCI的高危糖尿病患者采用替卡格雷治疗加或不加阿司匹林疗效比较

2020-04-02 MedSci原创 MedSci原创

与替卡格雷加阿司匹林相比,替卡格雷单药治疗降低临床相关出血风险而不增加缺血性事件的功效在接受PCI的糖尿病患者和非糖尿病患者中是一致的。

经皮冠状动脉介入治疗(PCI)后,经短暂的双抗血小板治疗再应用P2Y12抑制剂替卡格雷单药治疗可减少出血,但不增加缺血性损伤。这种方法对糖尿病患者的影响尚不清楚。近日,心血管领域权威杂志JACC上发表了一篇研究文章,该研究旨在评估单药替卡格雷与单药替卡格雷加阿司匹林治疗对接受PCI的糖尿病患者的疗效。  

这是一个对DM队列进行的预先设定分析。在采用替卡格雷加阿司匹林治疗3个月后,患者继续服用替卡格雷并随机分配到阿司匹林或安慰剂组治疗1年。该研究的主要终点是出血学术研究会(BARC)定义的2、3或5级出血。该研究的复合缺血终点为全因死亡、心肌梗死或卒中。  

糖尿病患者占随机队列的37% (n=2620),其特点是更频繁的合并症和更高患病率的多血管疾病。在随机分为替卡格雷+安慰剂组和替卡格雷+阿司匹林组的糖尿病患者中,BARC 2、3或5级出血的发生率分别为4.5%和6.7% (HR为0.65;95%可信区间为0.47-0.91;p=0.012)。与替卡格雷加阿司匹林相比,单药替卡格雷治疗与缺血性事件的增加无相关性(4.6% vs 5.9%;HR为0.77;95%CI为0.55-1.09;p=0.14)。在所有的试验人群中,糖尿病状态与治疗组之间对于原发性出血或缺血性终点没有显著的相互作用。  

由此可见,与替卡格雷加阿司匹林相比,替卡格雷单药治疗降低临床相关出血风险而不增加缺血性事件的功效在接受PCI的糖尿病患者和非糖尿病患者中是一致的。  

原始出处:  

Dominick J. Angiolillo,et al.Ticagrelor with or without Aspirin in High-Risk Patients with Diabetes Mellitus undergoing Percutaneous Coronary Intervention.Journal of the American College of Cardiology.2020;http://www.onlinejacc.org/content/early/2020/03/13/j.jacc.2020.03.008

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    2020-07-31 hbwxf
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    2020-04-02 内科新手

    谢谢梅斯提供这么好的信息,学到很多

    0

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    2020-04-02 misszhang

    谢谢MedSci提供最新的资讯

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