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Eur Heart J：稳定性冠脉病患者长期双抗治疗不良事件增多

2015-03-03 高晓方 译 医学论坛网

冠脉综合征稳定性冠脉疾病
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欧洲一项研究表明，与6个月的短期双重血小板治疗(简称双抗)相比，长期双抗治疗(24个月)时稳定性冠脉疾病(SCAD)患者的出血和净临床不良事件均显著增多。论文2月25日在线发表于《欧洲心脏杂志》(Eur Heart J)。 此项研究分别纳入1465和505例以急性冠脉综合征(ACS)和SCAD就诊的患者，并在冠脉支架置入后随机给予6或24个月双抗治疗。评估就双抗治疗持续时间而言，就诊时临床表

欧洲一项研究表明，与6个月的短期双重血小板治疗(简称双抗)相比，长期双抗治疗(24个月)时稳定性冠脉疾病(SCAD)患者的出血和净临床不良事件均显著增多。论文2月25日在线发表于《欧洲心脏杂志》(Eur Heart J)。

此项研究分别纳入1465和505例以急性冠脉综合征(ACS)和SCAD就诊的患者，并在冠脉支架置入后随机给予6或24个月双抗治疗。评估就双抗治疗持续时间而言，就诊时临床表现是否为转归修正因素。复合转归由24个月时的死亡、心梗或脑血管意外(CVA)组成。

结果显示，在ACS和SCAD患者中，长期和短期双抗治疗者的复合转归发生率均无显著差异。

在ACS患者中，长期双抗治疗与出血学术研究会(BARC)2、3或5级出血增加75%具有相关性[危险比(HR)1.75;P=0.015];在SCAD患者长期双抗治疗则与出血增加5倍具有相关性(HR 5.37;P=0.002)。

在接受24个月双重抗血小板治疗的SCAD患者中，净不良心血管事件增多一倍以上，在ACS患者则无此变化。

原始出处：

Costa F1, Vranckx P2, Leonardi S3, Moscarella E4, Ando G5, Calabro P4, Oreto G5, Zijlstra F6, Valgimigli M7.Impact of clinical presentation on ischaemic and bleeding outcomes in patients receiving 6- or 24-month duration of dual-antiplatelet therapy after stent implantation: a pre-specified analysis from the PRODIGY (Prolonging Dual-Antiplatelet Treatment After Grading Stent-Induced Intimal Hyperplasia) trial.Eur Heart J. 2015 Feb 25. pii: ehv038. [Epub ahead of print]

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    2015-03-08 fengyi812

    #冠脉病#

    0

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    2015-05-06 jiangfeng5067

    #稳定性#

    0

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    2015-03-05 hbwang006

    明白了

    0

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    2015-03-05 zhaojie88

    #ART#

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=2076437, encodeId=600720e643767, content=<a href='/topic/show?id=1e973098e62' target=_blank style='color:#2F92EE;'>#冠脉病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30987, encryptionId=1e973098e62, topicName=冠脉病)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a35a460, createdName=fengyi812, createdTime=Sun Mar 08 04:19:00 CST 2015, time=2015-03-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1900431, encodeId=af17190043130, content=<a href='/topic/show?id=0983e529745' target=_blank style='color:#2F92EE;'>#稳定性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=75297, encryptionId=0983e529745, topicName=稳定性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e0a1165, createdName=jiangfeng5067, createdTime=Wed May 06 18:19:00 CST 2015, time=2015-05-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=17801, encodeId=24d11e8017c, content=明白了, beContent=null, objectType=article, channel=null, level=null, likeNumber=156, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=hbwang006, createdTime=Thu Mar 05 23:49:00 CST 2015, time=2015-03-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1355975, encodeId=564813559e5db, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Thu Mar 05 00:19:00 CST 2015, time=2015-03-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1429110, encodeId=29341429110ce, content=<a href='/topic/show?id=168a3e464ad' target=_blank style='color:#2F92EE;'>#双抗治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37464, encryptionId=168a3e464ad, topicName=双抗治疗)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4f6a4173831, createdName=zhangbaojun, createdTime=Thu Mar 05 00:19:00 CST 2015, time=2015-03-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1487215, encodeId=1cf5148e21570, content=<a href='/topic/show?id=334b3e46139' target=_blank style='color:#2F92EE;'>#双抗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37461, encryptionId=334b3e46139, topicName=双抗)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=bbaa8296156, createdName=yeye5224615, createdTime=Thu Mar 05 00:19:00 CST 2015, time=2015-03-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1562300, encodeId=320815623009d, content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=80d715270048, createdName=slcumt, createdTime=Thu Mar 05 00:19:00 CST 2015, time=2015-03-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=17596, encodeId=b9a51e59608, content=有1年期组吗, beContent=null, objectType=article, channel=null, level=null, likeNumber=124, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=drhqh240, createdTime=Wed Mar 04 19:42:00 CST 2015, time=2015-03-04, status=1, ipAttribution=)]
    2015-03-05 zhangbaojun

    #双抗治疗#

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=2076437, encodeId=600720e643767, content=<a href='/topic/show?id=1e973098e62' target=_blank style='color:#2F92EE;'>#冠脉病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30987, encryptionId=1e973098e62, topicName=冠脉病)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a35a460, createdName=fengyi812, createdTime=Sun Mar 08 04:19:00 CST 2015, time=2015-03-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1900431, encodeId=af17190043130, content=<a href='/topic/show?id=0983e529745' target=_blank style='color:#2F92EE;'>#稳定性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=75297, encryptionId=0983e529745, topicName=稳定性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e0a1165, createdName=jiangfeng5067, createdTime=Wed May 06 18:19:00 CST 2015, time=2015-05-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=17801, encodeId=24d11e8017c, content=明白了, beContent=null, objectType=article, channel=null, level=null, likeNumber=156, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=hbwang006, createdTime=Thu Mar 05 23:49:00 CST 2015, time=2015-03-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1355975, encodeId=564813559e5db, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Thu Mar 05 00:19:00 CST 2015, time=2015-03-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1429110, encodeId=29341429110ce, content=<a href='/topic/show?id=168a3e464ad' target=_blank style='color:#2F92EE;'>#双抗治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37464, encryptionId=168a3e464ad, topicName=双抗治疗)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4f6a4173831, createdName=zhangbaojun, createdTime=Thu Mar 05 00:19:00 CST 2015, time=2015-03-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1487215, encodeId=1cf5148e21570, content=<a href='/topic/show?id=334b3e46139' target=_blank style='color:#2F92EE;'>#双抗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37461, encryptionId=334b3e46139, topicName=双抗)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=bbaa8296156, createdName=yeye5224615, createdTime=Thu Mar 05 00:19:00 CST 2015, time=2015-03-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1562300, encodeId=320815623009d, content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=80d715270048, createdName=slcumt, createdTime=Thu Mar 05 00:19:00 CST 2015, time=2015-03-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=17596, encodeId=b9a51e59608, content=有1年期组吗, beContent=null, objectType=article, channel=null, level=null, likeNumber=124, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=drhqh240, createdTime=Wed Mar 04 19:42:00 CST 2015, time=2015-03-04, status=1, ipAttribution=)]
    2015-03-05 yeye5224615

    #双抗#

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=2076437, encodeId=600720e643767, content=<a href='/topic/show?id=1e973098e62' target=_blank style='color:#2F92EE;'>#冠脉病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30987, encryptionId=1e973098e62, topicName=冠脉病)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a35a460, createdName=fengyi812, createdTime=Sun Mar 08 04:19:00 CST 2015, time=2015-03-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1900431, encodeId=af17190043130, content=<a href='/topic/show?id=0983e529745' target=_blank style='color:#2F92EE;'>#稳定性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=75297, encryptionId=0983e529745, topicName=稳定性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e0a1165, createdName=jiangfeng5067, createdTime=Wed May 06 18:19:00 CST 2015, time=2015-05-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=17801, encodeId=24d11e8017c, content=明白了, beContent=null, objectType=article, channel=null, level=null, likeNumber=156, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=hbwang006, createdTime=Thu Mar 05 23:49:00 CST 2015, time=2015-03-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1355975, encodeId=564813559e5db, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Thu Mar 05 00:19:00 CST 2015, time=2015-03-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1429110, encodeId=29341429110ce, content=<a href='/topic/show?id=168a3e464ad' target=_blank style='color:#2F92EE;'>#双抗治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37464, encryptionId=168a3e464ad, topicName=双抗治疗)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4f6a4173831, createdName=zhangbaojun, createdTime=Thu Mar 05 00:19:00 CST 2015, time=2015-03-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1487215, encodeId=1cf5148e21570, content=<a href='/topic/show?id=334b3e46139' target=_blank style='color:#2F92EE;'>#双抗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37461, encryptionId=334b3e46139, topicName=双抗)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=bbaa8296156, createdName=yeye5224615, createdTime=Thu Mar 05 00:19:00 CST 2015, time=2015-03-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1562300, encodeId=320815623009d, content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=80d715270048, createdName=slcumt, createdTime=Thu Mar 05 00:19:00 CST 2015, time=2015-03-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=17596, encodeId=b9a51e59608, content=有1年期组吗, beContent=null, objectType=article, channel=null, level=null, likeNumber=124, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=drhqh240, createdTime=Wed Mar 04 19:42:00 CST 2015, time=2015-03-04, status=1, ipAttribution=)]
    2015-03-05 slcumt

    #HEART#

    0

  8. [GetPortalCommentsPageByObjectIdResponse(id=2076437, encodeId=600720e643767, content=<a href='/topic/show?id=1e973098e62' target=_blank style='color:#2F92EE;'>#冠脉病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30987, encryptionId=1e973098e62, topicName=冠脉病)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a35a460, createdName=fengyi812, createdTime=Sun Mar 08 04:19:00 CST 2015, time=2015-03-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1900431, encodeId=af17190043130, content=<a href='/topic/show?id=0983e529745' target=_blank style='color:#2F92EE;'>#稳定性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=75297, encryptionId=0983e529745, topicName=稳定性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e0a1165, createdName=jiangfeng5067, createdTime=Wed May 06 18:19:00 CST 2015, time=2015-05-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=17801, encodeId=24d11e8017c, content=明白了, beContent=null, objectType=article, channel=null, level=null, likeNumber=156, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=hbwang006, createdTime=Thu Mar 05 23:49:00 CST 2015, time=2015-03-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1355975, encodeId=564813559e5db, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Thu Mar 05 00:19:00 CST 2015, time=2015-03-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1429110, encodeId=29341429110ce, content=<a href='/topic/show?id=168a3e464ad' target=_blank style='color:#2F92EE;'>#双抗治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37464, encryptionId=168a3e464ad, topicName=双抗治疗)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4f6a4173831, createdName=zhangbaojun, createdTime=Thu Mar 05 00:19:00 CST 2015, time=2015-03-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1487215, encodeId=1cf5148e21570, content=<a href='/topic/show?id=334b3e46139' target=_blank style='color:#2F92EE;'>#双抗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37461, encryptionId=334b3e46139, topicName=双抗)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=bbaa8296156, createdName=yeye5224615, createdTime=Thu Mar 05 00:19:00 CST 2015, time=2015-03-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1562300, encodeId=320815623009d, content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=80d715270048, createdName=slcumt, createdTime=Thu Mar 05 00:19:00 CST 2015, time=2015-03-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=17596, encodeId=b9a51e59608, content=有1年期组吗, beContent=null, objectType=article, channel=null, level=null, likeNumber=124, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=drhqh240, createdTime=Wed Mar 04 19:42:00 CST 2015, time=2015-03-04, status=1, ipAttribution=)]
    2015-03-04 drhqh240

    有1年期组吗

    0

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