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AJC：高残余血小板活性的ACS患者预后差(VIP研究)

2013-07-10 高晓方 译 cmt

急性冠脉综合征血小板活性
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意大利一项研究表明，在接受经皮冠脉介入（PCI）和支架置入的急性冠脉综合征（ACS）患者中，约1/3表现为高残余血小板活性（HRPR）并且伴有较差预后，但抑制血小板水平与缺血或出血事件的发生不独立相关。论文于6月7日在线发表于《美国心脏病学杂志》（Am J Cardiol）。 此项研究共纳入833例接受PCI和支架置入的非ST段抬高型ACS患者，并PCI后30天进行血

意大利一项研究表明，在接受经皮冠脉介入（PCI）和支架置入的急性冠脉综合征（ACS）患者中，约1/3表现为高残余血小板活性（HRPR）并且伴有较差预后，但抑制血小板水平与缺血或出血事件的发生不独立相关。论文于6月7日在线发表于《美国心脏病学杂志》（Am J Cardiol）。

此项研究共纳入833例接受PCI和支架置入的非ST段抬高型ACS患者，并PCI后30天进行血小板抑制床旁检测。以P2Y12反应单位>230诊断HRPR。评估死亡、心肌梗死、卒中和严重出血事件的发生率和预测因子。

结果显示，P2Y12反应单位分布正常；264例患者被分类为应答不佳者（31.7%）。氯吡格雷应答的独立预测因素为男性、年龄、糖尿病和质子泵抑制剂应用。1年时，应答不佳者的死亡率和严重出血事件发生率均高于应答良好者。对混淆因素进行校正之后，HRPR并非死亡或严重出血事件的独立预测因素。以P2Y12反应单位208为阈值未改变上述结果。


Incidence and Outcome of High On-Treatment Platelet Reactivity in Patients With Non-ST Elevation Acute Coronary Syndromes Undergoing Percutaneous Coronary Intervention (from the VIP [VerifyNow and Inhibition of Platelet Reactivity] Study)  

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  1. [GetPortalCommentsPageByObjectIdResponse(id=1746681, encodeId=f6d51e46681b7, content=<a href='/topic/show?id=fd271844257' target=_blank style='color:#2F92EE;'>#VIP#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=18442, encryptionId=fd271844257, topicName=VIP)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=933235833639, createdName=chendoc254, createdTime=Thu Oct 03 00:24:00 CST 2013, time=2013-10-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1691808, encodeId=fcdc16918087f, content=<a href='/topic/show?id=a450530853c' target=_blank style='color:#2F92EE;'>#患者预后#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=53085, encryptionId=a450530853c, topicName=患者预后)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8f4729287700, createdName=bnurmamat, createdTime=Sat Feb 22 18:24:00 CST 2014, time=2014-02-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1279013, encodeId=d43d12e9013c3, content=<a href='/topic/show?id=316d1882bc' target=_blank style='color:#2F92EE;'>#ACS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, 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 Jul 12 08:24:00 CST 2013, time=2013-07-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1574953, encodeId=658615e495380, content=<a href='/topic/show?id=52ab188e48' target=_blank style='color:#2F92EE;'>#ACS患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1887, encryptionId=52ab188e48, topicName=ACS患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=bf9f16042984, createdName=neurosurgeon, createdTime=Fri Jul 12 08:24:00 CST 2013, time=2013-07-12, status=1, ipAttribution=)]
    2013-10-03 chendoc254

    #VIP#

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=1746681, encodeId=f6d51e46681b7, content=<a href='/topic/show?id=fd271844257' target=_blank style='color:#2F92EE;'>#VIP#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=18442, encryptionId=fd271844257, topicName=VIP)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=933235833639, createdName=chendoc254, createdTime=Thu Oct 03 00:24:00 CST 2013, time=2013-10-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1691808, encodeId=fcdc16918087f, content=<a href='/topic/show?id=a450530853c' target=_blank style='color:#2F92EE;'>#患者预后#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=53085, encryptionId=a450530853c, topicName=患者预后)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8f4729287700, createdName=bnurmamat, createdTime=Sat Feb 22 18:24:00 CST 2014, time=2014-02-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1279013, encodeId=d43d12e9013c3, content=<a href='/topic/show?id=316d1882bc' target=_blank style='color:#2F92EE;'>#ACS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, 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 Jul 12 08:24:00 CST 2013, time=2013-07-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1574953, encodeId=658615e495380, content=<a href='/topic/show?id=52ab188e48' target=_blank style='color:#2F92EE;'>#ACS患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1887, encryptionId=52ab188e48, topicName=ACS患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=bf9f16042984, createdName=neurosurgeon, createdTime=Fri Jul 12 08:24:00 CST 2013, time=2013-07-12, status=1, ipAttribution=)]
    2014-02-22 bnurmamat

    #患者预后#

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=1746681, encodeId=f6d51e46681b7, content=<a href='/topic/show?id=fd271844257' target=_blank style='color:#2F92EE;'>#VIP#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=18442, encryptionId=fd271844257, topicName=VIP)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=933235833639, createdName=chendoc254, createdTime=Thu Oct 03 00:24:00 CST 2013, time=2013-10-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1691808, encodeId=fcdc16918087f, content=<a href='/topic/show?id=a450530853c' target=_blank style='color:#2F92EE;'>#患者预后#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=53085, encryptionId=a450530853c, topicName=患者预后)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8f4729287700, createdName=bnurmamat, createdTime=Sat Feb 22 18:24:00 CST 2014, time=2014-02-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1279013, encodeId=d43d12e9013c3, content=<a href='/topic/show?id=316d1882bc' target=_blank style='color:#2F92EE;'>#ACS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, 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 Jul 12 08:24:00 CST 2013, time=2013-07-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1574953, encodeId=658615e495380, content=<a href='/topic/show?id=52ab188e48' target=_blank style='color:#2F92EE;'>#ACS患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1887, encryptionId=52ab188e48, topicName=ACS患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=bf9f16042984, createdName=neurosurgeon, createdTime=Fri Jul 12 08:24:00 CST 2013, time=2013-07-12, status=1, ipAttribution=)]
    2013-07-12 yaanren

    #ACS#

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=1746681, encodeId=f6d51e46681b7, content=<a href='/topic/show?id=fd271844257' target=_blank style='color:#2F92EE;'>#VIP#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=18442, encryptionId=fd271844257, topicName=VIP)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=933235833639, createdName=chendoc254, createdTime=Thu Oct 03 00:24:00 CST 2013, time=2013-10-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1691808, encodeId=fcdc16918087f, content=<a href='/topic/show?id=a450530853c' target=_blank style='color:#2F92EE;'>#患者预后#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=53085, encryptionId=a450530853c, topicName=患者预后)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8f4729287700, createdName=bnurmamat, createdTime=Sat Feb 22 18:24:00 CST 2014, time=2014-02-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1279013, encodeId=d43d12e9013c3, content=<a href='/topic/show?id=316d1882bc' target=_blank style='color:#2F92EE;'>#ACS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, 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 Jul 12 08:24:00 CST 2013, time=2013-07-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1574953, encodeId=658615e495380, content=<a href='/topic/show?id=52ab188e48' target=_blank style='color:#2F92EE;'>#ACS患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1887, encryptionId=52ab188e48, topicName=ACS患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=bf9f16042984, createdName=neurosurgeon, createdTime=Fri Jul 12 08:24:00 CST 2013, time=2013-07-12, status=1, ipAttribution=)]
    2013-07-12 neurosurgeon

    #ACS患者#

    0

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