Eur Heart J :全球多中心注册研究 肿瘤心脏病学亟待发展

2017-06-14 朱柳媛 中国循环杂志

包括北京安贞医院在内的全球注册研究——BleeMACS研究的最新亚组分析提示,在接受经皮冠状动脉介入治疗(PCI)的急性冠脉综合征患者中,合并癌症的急性冠脉综合征患者1年死亡或再次心梗的风险增加1.1倍,出血风险增加50%。

包括北京安贞医院在内的全球注册研究——BleeMACS研究的最新亚组分析提示,在接受经皮冠状动脉介入治疗(PCI)的急性冠脉综合征患者中,合并癌症的急性冠脉综合征患者1年死亡或再次心梗的风险增加1.1倍,出血风险增加50%。
研究中,癌症合并率为6.4%,其完全血运重建和冠心病二级预防药物的应用率相对较低。
多因素分析表明,合并癌症是这类患者PCI后1年死亡/再次心梗以及出血的最强烈的预测因素。
该分析显示,癌症患者接受完全血运重建的比例较低。研究者分析认为,这可能与人们认为这类患者需要进一步处理以及支架血栓形成的风险较高有关。
双联抗血小板治疗对癌症患者有生存益处,规律接受双联抗血小板治疗的癌症患者死亡风险降低50%。
合并癌症的患者年龄相对较大,女性较多,糖尿病高血压卒中心衰、慢性肾脏病等疾病合并率较高,既往有急性冠脉综合征和出血史的人也较多。

原文出处:
Iannaccone M, D'Ascenzo F, Vadalà P, et al. Prevalence and outcome of patients with cancer and acute coronary syndrome undergoing percutaneous coronary intervention: a BleeMACS substudy. Eur Heart J Acute Cardiovasc Care. 2017 Jun 1:2048872617706501.

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    2018-03-10 qblt
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    2017-06-17 方舒

    学习

    0

  5. 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    2017-06-16 zhaojie88
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    2017-06-16 zhyy93
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encodeId=7d292106e90e, content=好好学习,感谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Wed Jun 14 13:48:39 CST 2017, time=2017-06-14, status=1, ipAttribution=)]
    2017-06-16 slcumt
  8. 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encodeId=7d292106e90e, content=好好学习,感谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Wed Jun 14 13:48:39 CST 2017, time=2017-06-14, status=1, ipAttribution=)]
    2017-06-15 ylzr123

    认真学习,把间接经验应用到临床实践中去,然后再总结出新思路。给点赞啦

    0

  9. 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encodeId=7d292106e90e, content=好好学习,感谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Wed Jun 14 13:48:39 CST 2017, time=2017-06-14, status=1, ipAttribution=)]
    2017-06-14 luominglian113

    学习了,谢谢分享

    0

  10. 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encodeId=7d292106e90e, content=好好学习,感谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Wed Jun 14 13:48:39 CST 2017, time=2017-06-14, status=1, ipAttribution=)]
    2017-06-14 虈亣靌

    好好学习,感谢分享

    0

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近日,国际权威医学期刊《新英格兰医学杂志》(NEJM)发表的一篇评论通过大样本的调查数据抨击了美国的过度医疗问题,对临床医生和医疗管理者有着较为深刻的启发意义.

J Med Chem:针对 NOD2 靶点的肿瘤治疗策略

近日,清华大学药学院刘刚教授课题组在国际上首次报道了拮抗模式识别受体 NOD2 介导的炎症信号通路可增敏化疗药紫杉醇(PTX)的疗效,实现了负调节肿瘤微环境,逆转化疗抵抗并抑制肿瘤转移。基于此研究思路,刘刚教授课题组将化学治疗及免疫治疗的双功能整合在一个分子中,成功开发了 1.1 类抗肿瘤新药康莫他赛,目前已获批开展临床试验。针对肿瘤微环境的免疫治疗药物是目前的研究热点。肿瘤微环境中多种炎性细胞、

划时代!FDA&#160今日加速批准**不区分肿瘤来源的抗癌疗法

今日,美国 FDA 传来一条重量级消息——由默沙东(MSD)带来的 KEYTRUDA(pembrolizumab)获批治疗带有微卫星不稳定性高(microsatellite instability-high,MSI-H)或错配修复缺陷(mismatch repair deficient,dMMR)的实体瘤患者,他们的病情在先前的治疗后都出现了进展。值得一提的是,这是美国 FDA 批准的首款

从实验室到临床:转化医学推动肿瘤免疫治疗迈入 2.0 时代

要说近些年肿瘤治疗领域最受关注和值得期待的研究突破,免疫治疗可谓当仁不让。

Oncotarget:PRPF的超表达可以通过肌动蛋白细胞骨架重排和上皮间质转化诱导抗药性产生

mRNA前体加工因子(PRPF)4B激酶属于类CDK激酶家族成员,并且参与mRNA前体剪切和信号转导。最近,有研究人员观察到了PRPF的超表达可以减少细胞内活性氧种类水平,并且在HCT116人类结肠癌细胞中,可以通过激活细胞存活信号蛋白 NFκB,、ERK、 和 c-MYC抑制白藜芦醇诱导的细胞凋亡。研究发现,PRPF的超表达改变了细胞学形态,并且通过调控Rho家族蛋白的活性,实现对肌动蛋白细胞骨

Science:肿瘤基因修复缺陷使免疫疗法更有效

来自约翰霍普金斯医学院的研究人员们进行了为期三年的扩大临床试验,参与者为包括直结肠癌在内的12种不同的癌症,这些癌症都存在所谓的“错配修复基因缺陷”,在实验过程中,研究人员发现,半数患者对抗癌药物派姆单抗(pembrolizumab)有反应。基于此次研究的发现,美国食品和药品管理局批准扩大抗癌药派姆单抗的适用范围。