Heart：VKA或增STEMI患者院内大出血风险

2014-10-29 高晓方译医学论坛网

美国一项研究表明，在接受直接经皮冠脉介入治疗(PCI)治疗的ST段抬高型心肌梗死(STEMI)患者中，无论患者入院国际标准化比值(INR)是否≥2，长期用维生素K拮抗剂(VKA)与其院内大出血风险显著升高具有相关性。在该研究中，糖蛋白IIb/IIIa抑制剂(GPI)与出血风险增加有关，而比伐卢定则与风险减少相关。论文于10月21日在线发表于《心脏》(Heart)。此项研究对120270

美国一项研究表明，在接受直接经皮冠脉介入治疗(PCI)治疗的ST段抬高型心肌梗死(STEMI)患者中，无论患者入院国际标准化比值(INR)是否≥2，长期用维生素K拮抗剂(VKA)与其院内大出血风险显著升高具有相关性。在该研究中，糖蛋白IIb/IIIa抑制剂(GPI)与出血风险增加有关，而比伐卢定则与风险减少相关。论文于10月21日在线发表于《心脏》(Heart)。

此项研究对120270例接受直接PCI的STEMI患者进行了回顾性调查。评估VKA长期治疗与院内大出血风险的相关性，并确定出血与依据INR分层急性治疗的相关性。

结果显示，与未接受VKA治疗的患者相比，3010例VKA治疗者与院内大出血风险升高具有相关性(17.0%对10.1%，校正OR 1.26)。在VKA治疗者中，与入院时INR <2.0相比，入院时INR≥2.0与出血风险增加无相关性。

VKA治疗更有可能在就诊24小时内(急性)接受氯吡格雷或比伐卢定治疗，而较少可能接受普拉格雷、肝素或GPI治疗。在此类患者中，GPI急性应用与出血风险增加具有相关性，比伐卢定则与风险减少相关。INR≥2.0和<2.0患者在肝素、比伐卢定、ADP受体阻断剂和GPI相关性出血风险方面无差异。

原始出处：

Karrowni W1, Wang TY2, Chen AY2, Thomas L2, Saucedo JF3, El Accaoui RN4.Chronic vitamin K antagonist therapy and bleeding risk in ST elevation myocardial infarction patients.Heart. 2014 Oct 21. pii: heartjnl-2014-305931. doi: 10.1136/heartjnl-2014-305931. [Epub ahead of print]

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2015-07-19 12498c32m68暂无昵称

#STEMI患者#

62 0
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2015-01-18 circumcision

#院内大出血风险#

67 0
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2015-02-21 zhwj

#VKA#

76 0
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2014-10-31 cmsvly

#大出血#

68 0
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2014-10-31 zhaojie88

#ART#

62 0
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2014-10-31 12498bb3m92(暂无昵称)

#STEM#

65 0
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2014-10-31 爆笑小医

#HEART#

57 0

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