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Circulation:糖尿病患者冠状动脉支架术后心肌梗死的预防

2016-04-06 phylis 译 MedSci原创

背景:冠状动脉支架术后,糖尿病(DM)患者复发性脑缺血事件发生的风险很高。研究者评估参与双联抗血小板治疗研究(DAPT)中糖尿病患者持续应用噻吩并吡啶的影响。方法:冠状动脉内支架植入术后,噻吩吡啶类药物加阿司匹林治疗12个月。11648例非缺血性或出血事件的患者,根据用药随机分为持续的噻吩吡啶类药物联合阿司匹林或安慰剂联合阿司匹林。结果:与非糖尿病患者(8257例)相比,糖尿病患者(3391例)死

背景:冠状动脉支架术后,糖尿病(DM)患者复发性脑缺血事件发生的风险很高。研究者评估了参与双联抗血小板治疗研究(DAPT)中的糖尿病患者持续应用噻吩并吡啶抗血小板药(噻氯匹定或氯吡格雷)的结果。
方法:研究者选取冠状动脉内支架植入术后,噻吩吡啶类药物联合阿司匹林治疗12个月非缺血性或出血事件的患者11648例。根据用药将患者随机分为继续噻吩吡啶类药物联合阿司匹林或安慰剂联合阿司匹林治疗18个月。

结果:与非糖尿病患者(8257例)相比,糖尿病患者(3391例)死亡、心肌梗死、脑卒中复合预后(6.8% VS 4.3%)发生率较高,死亡(1.4%vs2.5%)和MI(2.6% vs 4.2%)的发生率也较高。糖尿病患者中,继续噻吩并吡啶药物组与安慰剂组比,患者支架内血栓发生为0.5% vs 1.1%;MI的发生率为3.5% vs 4.8%。在非糖尿病患者中,两组患者支架内血栓的发生率为0.4% vs 1.4%,MI的发生率分别为1.6% vs 3.6%。持续应用噻吩并吡啶治疗的糖尿病患者和非糖尿病患者,出血风险相似(交互作用P = 0.61)。

结论:糖尿病患者中,冠状动脉支架置入术后服用噻吩吡啶类药物超过1年与心肌梗死的风险降低有关,与无糖尿病患者相比,相关性减弱。

原文出处:

Meredith IT, Tanguay JF, et al. Diabetes Mellitus and Prevention of Late Myocardial Infarction After Coronary Stenting in the Randomized Dual Antiplatelet Therapy Study. Circulation. 2016 Mar 18.

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    2016-12-25 gujh
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    2016-06-13 qindq
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    2016-05-12 1deccd6bm00(暂无匿称)

    好好认真学习

    0

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    2016-04-08 1de5aaa9m95(暂无匿称)

    替格瑞洛可以代替吗?

    0

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