JAMA:替格瑞洛单药vs替格瑞洛+阿司匹林对ACS支架患者不良临床事件的影响

2020-06-17 MedSci原创 MedSci原创

对于接受药物洗脱支架治疗的ACS患者,在3个月的双重抗血小板治疗后转为替卡格雷单药治疗可降低大出血和心血管事件风险

短期使用双重抗血小板治疗(DAPT)后停用阿司匹林被认为可减少出血风险,近日研究人员考察了对于接受药物洗脱支架治疗的ACS患者,在3个月DAPT治疗后转为替格瑞洛单药治疗与以替卡格雷为基础的12个月DAPT,对减少不良临床事件的影响。
 
研究在韩国开展,3056名接受药物洗脱支架治疗的ACS患者参与,随机在3个月DAPT治疗后转为替格瑞洛单药治疗(n=1527)或12个月以替卡格雷为基础的DAPT治疗(n=1529)。研究的主要结果是1年的净不良临床事件,定义为主要出血和心脑血管不良事件(死亡、心肌梗死、支架血栓形成、中风或靶血管重建),次要结果包括严重出血和严重心脑血管不良事件。
 
患者平均年龄61岁,628名女性(20%),36%的患者存在ST段抬高型心肌梗死,2978名患者(97.4%)完成了试验。替格瑞洛单药组59名患者发生主要结果(3.9%),而12个月DAPT组89名(5.9%)患者发生主要终点事件(绝对差异,-1.98%;危险比[HR]:0.66)。在10个预先指定的次要结果中,8个无显著性差异。
 
研究认为,对于接受药物洗脱支架治疗的ACS患者,在3个月的双重抗血小板治疗后转为替格瑞洛单药治疗可降低大出血和心血管事件风险。
 
原始出处:
 

版权声明:
本网站所有内容来源注明为“梅斯医学”或“MedSci原创”的文字、图片和音视频资料,版权均属于梅斯医学所有。非经授权,任何媒体、网站或个人不得转载,授权转载时须注明来源为“梅斯医学”。其它来源的文章系转载文章,或“梅斯号”自媒体发布的文章,仅系出于传递更多信息之目的,本站仅负责审核内容合规,其内容不代表本站立场,本站不负责内容的准确性和版权。如果存在侵权、或不希望被转载的媒体或个人可与我们联系,我们将立即进行删除处理。
在此留言
评论区 (4)
#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=1279348, encodeId=d4bf12e934843, content=<a href='/topic/show?id=316d1882bc' target=_blank style='color:#2F92EE;'>#ACS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1882, encryptionId=316d1882bc, topicName=ACS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=102a153, createdName=yaanren, createdTime=Fri Jun 19 09:47:10 CST 2020, time=2020-06-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=602469, encodeId=e68960246919, content=可降低风险, beContent=null, objectType=article, channel=null, level=null, likeNumber=121, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200529/3611e9bb629c4e5b81fbd8ce784b06cc/128487eae357460bb98f67d86230c218.jpg, createdBy=ab235268530, createdName=神盾医疗局局长Jack, createdTime=Thu Jun 18 09:18:41 CST 2020, time=2020-06-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1036136, encodeId=f77e1036136d3, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Wed Jun 17 21:47:10 CST 2020, time=2020-06-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=602431, encodeId=8c716024311f, content=<a href='/topic/show?id=fec0188415' target=_blank style='color:#2F92EE;'>#ACS/急性冠脉综合征#</a>即替格瑞洛, beContent=null, objectType=article, channel=null, level=null, likeNumber=131, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1884, encryptionId=fec0188415, topicName=ACS/急性冠脉综合征)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220519/c2ab253484ee4527a2d4e9589a4821ac/45de9bf494a54becb2ea4369c9d11e85.jpg, createdBy=7a3710, createdName=lovetcm, createdTime=Wed Jun 17 20:27:23 CST 2020, time=2020-06-17, status=1, ipAttribution=)]
    2020-06-19 yaanren
  2. [GetPortalCommentsPageByObjectIdResponse(id=1279348, encodeId=d4bf12e934843, content=<a href='/topic/show?id=316d1882bc' target=_blank style='color:#2F92EE;'>#ACS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1882, encryptionId=316d1882bc, topicName=ACS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=102a153, createdName=yaanren, createdTime=Fri Jun 19 09:47:10 CST 2020, time=2020-06-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=602469, encodeId=e68960246919, content=可降低风险, beContent=null, objectType=article, channel=null, level=null, likeNumber=121, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200529/3611e9bb629c4e5b81fbd8ce784b06cc/128487eae357460bb98f67d86230c218.jpg, createdBy=ab235268530, createdName=神盾医疗局局长Jack, createdTime=Thu Jun 18 09:18:41 CST 2020, time=2020-06-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1036136, encodeId=f77e1036136d3, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Wed Jun 17 21:47:10 CST 2020, time=2020-06-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=602431, encodeId=8c716024311f, content=<a href='/topic/show?id=fec0188415' target=_blank style='color:#2F92EE;'>#ACS/急性冠脉综合征#</a>即替格瑞洛, beContent=null, objectType=article, channel=null, level=null, likeNumber=131, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1884, encryptionId=fec0188415, topicName=ACS/急性冠脉综合征)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220519/c2ab253484ee4527a2d4e9589a4821ac/45de9bf494a54becb2ea4369c9d11e85.jpg, createdBy=7a3710, createdName=lovetcm, createdTime=Wed Jun 17 20:27:23 CST 2020, time=2020-06-17, status=1, ipAttribution=)]
    2020-06-18 神盾医疗局局长Jack

    可降低风险

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=1279348, encodeId=d4bf12e934843, content=<a href='/topic/show?id=316d1882bc' target=_blank style='color:#2F92EE;'>#ACS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1882, encryptionId=316d1882bc, topicName=ACS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=102a153, createdName=yaanren, createdTime=Fri Jun 19 09:47:10 CST 2020, time=2020-06-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=602469, encodeId=e68960246919, content=可降低风险, beContent=null, objectType=article, channel=null, level=null, likeNumber=121, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200529/3611e9bb629c4e5b81fbd8ce784b06cc/128487eae357460bb98f67d86230c218.jpg, createdBy=ab235268530, createdName=神盾医疗局局长Jack, createdTime=Thu Jun 18 09:18:41 CST 2020, time=2020-06-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1036136, encodeId=f77e1036136d3, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Wed Jun 17 21:47:10 CST 2020, time=2020-06-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=602431, encodeId=8c716024311f, content=<a href='/topic/show?id=fec0188415' target=_blank style='color:#2F92EE;'>#ACS/急性冠脉综合征#</a>即替格瑞洛, beContent=null, objectType=article, channel=null, level=null, likeNumber=131, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1884, encryptionId=fec0188415, topicName=ACS/急性冠脉综合征)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220519/c2ab253484ee4527a2d4e9589a4821ac/45de9bf494a54becb2ea4369c9d11e85.jpg, createdBy=7a3710, createdName=lovetcm, createdTime=Wed Jun 17 20:27:23 CST 2020, time=2020-06-17, status=1, ipAttribution=)]
    2020-06-17 旺医

    顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=1279348, encodeId=d4bf12e934843, content=<a href='/topic/show?id=316d1882bc' target=_blank style='color:#2F92EE;'>#ACS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1882, encryptionId=316d1882bc, topicName=ACS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=102a153, createdName=yaanren, createdTime=Fri Jun 19 09:47:10 CST 2020, time=2020-06-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=602469, encodeId=e68960246919, content=可降低风险, beContent=null, objectType=article, channel=null, level=null, likeNumber=121, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200529/3611e9bb629c4e5b81fbd8ce784b06cc/128487eae357460bb98f67d86230c218.jpg, createdBy=ab235268530, createdName=神盾医疗局局长Jack, createdTime=Thu Jun 18 09:18:41 CST 2020, time=2020-06-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1036136, encodeId=f77e1036136d3, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Wed Jun 17 21:47:10 CST 2020, time=2020-06-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=602431, encodeId=8c716024311f, content=<a href='/topic/show?id=fec0188415' target=_blank style='color:#2F92EE;'>#ACS/急性冠脉综合征#</a>即替格瑞洛, beContent=null, objectType=article, channel=null, level=null, likeNumber=131, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1884, encryptionId=fec0188415, topicName=ACS/急性冠脉综合征)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220519/c2ab253484ee4527a2d4e9589a4821ac/45de9bf494a54becb2ea4369c9d11e85.jpg, createdBy=7a3710, createdName=lovetcm, createdTime=Wed Jun 17 20:27:23 CST 2020, time=2020-06-17, status=1, ipAttribution=)]
    2020-06-17 lovetcm

相关资讯

ACS术后又发心律失常,CCU主任是怎么做的?

室性心律失常包括室性早搏(室早)、非持续性与持续性室性心动过速(室速)、心室扑动(室扑)与心室颤动(室颤)。

BMJ:肌钙蛋白、年龄与患者预后

研究认为,肌钙蛋白水平高于正常上限人群的死亡风险增加,且不受年龄的影响,特别是阳性患者在检测后前几周内集中死亡风险极高

JAMA Intern Med:PCI后ACS患者主要冠状动脉不良事件的预防——替卡格雷vs氯吡格雷

研究发现,PCI后,使用替卡格雷或氯吡格雷预防主要冠状动脉不良事件的效果相当,但替卡格雷使用人群的出血和呼吸困难风险增加

Lancet Diabetes Endo:alirocumab可大幅降低新近ACS患者后继心血管事件风险

研究认为,对于近期发生急性冠状动脉综合征的患者,接受alirocumab治疗可大幅降低患者后继心血管事件风险

ACS病因就是冠脉斑块破裂?没那么简单!这些病因你想到过吗?

下面共有6个ACS的病例,您觉得他们的病因是什么呢?

中国ACS患者血脂管理的现状与挑战

为进一步优化中国急性冠脉综合征(Acute coronary syndrome,ACS)患者全程管理,尤其是其长期血脂管理。2019欧洲心脏病学会(ESC)年会期间来自中国的三位心血管病学专家:北京大学第一医院霍勇教授、复旦大学中山医院葛均波院士以及中国人民解放军总医院陈韵岱教授与多位欧洲专家共同参与了“中欧ACS标准化管理学术交流启动会”。三位专家在会上也对中国ACS患者全程管理,尤其是血脂管理