EUR HEART J-CARD PHA：吸烟与急性冠状动脉综合征患者抗血小板治疗降级后的结果

2021-01-04 MedSci原创 MedSci原创

前期研究揭示吸烟者和非吸烟者之间抗血小板药物反应和临床结果存在差异，因此任何双重抗血小板治疗(DAPT)降级策略的安全性和有效性可能与吸烟状况有关。

前期研究揭示吸烟者和非吸烟者之间抗血小板药物反应和临床结果存在差异，因此任何双重抗血小板治疗(DAPT)降级策略的安全性和有效性可能与吸烟状况有关。因此，本研究评估了吸烟对急性冠脉综合征(ACS)患者的临床结果和二磷酸腺苷诱导血小板聚集的影响。

多中心热带-ACS试验将2610例生物标志物阳性的ACS患者按1:1的比例随机分组，接受普拉格雷标准治疗12个月(对照组)或血小板功能检测指导下DAPT降升。目前吸烟者(n = 1182)显示研究组之间的事件发生率具有可比性[6.6% vs. 6.6%;危险比(HR) 1.0, 95%置信区间(CI) 0.64-1.56, P > 0.99]。在非吸烟者(n = 1428)中，引导DAPT降级与对照组患者相比(7.9%对11.0%;HR 0.71, 95% CI 0.50-0.99, P = 0.048)。这主要是BARC≥2级出血率降低所致(5.2% vs. 7.7%;HR 0.68, 95% CI 0.45-1.03, P = 0.066)。吸烟状态与引导DAPT降级治疗效果无显著交互作用(Pint = 0.23)。腺苷diphosphate-induced血小板聚集值高于吸烟者(平均28 U,四分位范围(IQR: 20 - 40)]与不吸烟(平均24 UIQR（16-25）,P < 0.0001),对照组和吸烟者(平均42 U, IQR (27 - 68)]与不吸烟(中位数37 U, IQR (25-55),监控组P < 0.001)。

研究结果表明，引导DAPT降级似乎对吸烟者和非吸烟者同样安全和有效。无论是否吸烟，特别是对于那些被认为不适合进行1年强效血小板抑制的患者，DAPT策略可能被用作抗血小板治疗方案的替代方案。

原始出处：

Martin Orban, Dietmar Trenk,Smoking and outcomes following guided de-escalation of antiplatelet treatment in acute coronary syndrome patients: a substudy from the randomized TROPICAL-ACS trial

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2021-08-15 124985dbm16(暂无昵称)

#冠状动脉综合征#

74 0
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2021-01-11 ms2000001051330459

学习了，涨知识了！

144 0
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2021-01-06 zhaojie88

#ART#

71 0
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2021, time=2021-01-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=913682, encodeId=f88f91368275, content=吸烟有害健康, beContent=null, objectType=article, channel=null, level=null, likeNumber=135, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b2b82397018, createdName=12346c4dm64暂无昵称, createdTime=Mon Jan 04 19:29:56 CST 2021, time=2021-01-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=913636, encodeId=d16c91363639, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=136, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ae605445021, createdName=ludan233, createdTime=Mon Jan 04 17:26:53 CST 2021, time=2021-01-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=913607, encodeId=523a91360e54, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=49db1605285, createdName=yinier, createdTime=Mon Jan 04 15:22:27 CST 2021, time=2021-01-04, status=1, ipAttribution=)]
2021-01-06 zhouqu_8

#综合征#

71 0
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2021, time=2021-01-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=913682, encodeId=f88f91368275, content=吸烟有害健康, beContent=null, objectType=article, channel=null, level=null, likeNumber=135, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b2b82397018, createdName=12346c4dm64暂无昵称, createdTime=Mon Jan 04 19:29:56 CST 2021, time=2021-01-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=913636, encodeId=d16c91363639, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=136, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ae605445021, createdName=ludan233, createdTime=Mon Jan 04 17:26:53 CST 2021, time=2021-01-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=913607, encodeId=523a91360e54, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=49db1605285, createdName=yinier, createdTime=Mon Jan 04 15:22:27 CST 2021, time=2021-01-04, status=1, ipAttribution=)]
2021-01-06 slcumt

#HEART#

81 0
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2021, time=2021-01-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=913682, encodeId=f88f91368275, content=吸烟有害健康, beContent=null, objectType=article, channel=null, level=null, likeNumber=135, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b2b82397018, createdName=12346c4dm64暂无昵称, createdTime=Mon Jan 04 19:29:56 CST 2021, time=2021-01-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=913636, encodeId=d16c91363639, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=136, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ae605445021, createdName=ludan233, createdTime=Mon Jan 04 17:26:53 CST 2021, time=2021-01-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=913607, encodeId=523a91360e54, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=49db1605285, createdName=yinier, createdTime=Mon Jan 04 15:22:27 CST 2021, time=2021-01-04, status=1, ipAttribution=)]
2021-01-05 liyu7822

禁烟很重要啊

145 0
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2021, time=2021-01-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=913682, encodeId=f88f91368275, content=吸烟有害健康, beContent=null, objectType=article, channel=null, level=null, likeNumber=135, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b2b82397018, createdName=12346c4dm64暂无昵称, createdTime=Mon Jan 04 19:29:56 CST 2021, time=2021-01-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=913636, encodeId=d16c91363639, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=136, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ae605445021, createdName=ludan233, createdTime=Mon Jan 04 17:26:53 CST 2021, time=2021-01-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=913607, encodeId=523a91360e54, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=49db1605285, createdName=yinier, createdTime=Mon Jan 04 15:22:27 CST 2021, time=2021-01-04, status=1, ipAttribution=)]
2021-01-04 ms4000000529616129

学习到了

157 0
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style='color:#2F92EE;'>#综合征#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79124, encryptionId=f9b9e9124a8, topicName=综合征)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Wed Jan 06 01:04:50 CST 2021, time=2021-01-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1563398, encodeId=067e1563398dc, content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=81, 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=Wed Jan 06 01:04:50 CST 2021, time=2021-01-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=913895, encodeId=4175913895b1, content=禁烟很重要啊, beContent=null, objectType=article, channel=null, level=null, likeNumber=145, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200914/f1df8506d5cb4909bac2efc340b6c1fe/dcc6dd2dbec44613838b555fbe723804.jpg, createdBy=686b1371609, createdName=liyu7822, createdTime=Tue Jan 05 16:15:22 CST 2021, time=2021-01-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=913710, encodeId=c72a913e10e2, content=学习到了, beContent=null, objectType=article, channel=null, level=null, likeNumber=157, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8db85450012, createdName=ms4000000529616129, createdTime=Mon Jan 04 21:20:57 CST 2021, time=2021-01-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=913682, encodeId=f88f91368275, content=吸烟有害健康, beContent=null, objectType=article, channel=null, level=null, likeNumber=135, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b2b82397018, createdName=12346c4dm64暂无昵称, createdTime=Mon Jan 04 19:29:56 CST 2021, time=2021-01-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=913636, encodeId=d16c91363639, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=136, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ae605445021, createdName=ludan233, createdTime=Mon Jan 04 17:26:53 CST 2021, time=2021-01-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=913607, encodeId=523a91360e54, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=49db1605285, createdName=yinier, createdTime=Mon Jan 04 15:22:27 CST 2021, time=2021-01-04, status=1, ipAttribution=)]
2021-01-04 12346c4dm64暂无昵称

吸烟有害健康

135 0
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createdName=slcumt, createdTime=Wed Jan 06 01:04:50 CST 2021, time=2021-01-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=913895, encodeId=4175913895b1, content=禁烟很重要啊, beContent=null, objectType=article, channel=null, level=null, likeNumber=145, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200914/f1df8506d5cb4909bac2efc340b6c1fe/dcc6dd2dbec44613838b555fbe723804.jpg, createdBy=686b1371609, createdName=liyu7822, createdTime=Tue Jan 05 16:15:22 CST 2021, time=2021-01-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=913710, encodeId=c72a913e10e2, content=学习到了, beContent=null, objectType=article, channel=null, level=null, likeNumber=157, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8db85450012, createdName=ms4000000529616129, createdTime=Mon Jan 04 21:20:57 CST 2021, time=2021-01-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=913682, encodeId=f88f91368275, content=吸烟有害健康, beContent=null, objectType=article, channel=null, level=null, likeNumber=135, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b2b82397018, createdName=12346c4dm64暂无昵称, createdTime=Mon Jan 04 19:29:56 CST 2021, time=2021-01-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=913636, encodeId=d16c91363639, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=136, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ae605445021, createdName=ludan233, createdTime=Mon Jan 04 17:26:53 CST 2021, time=2021-01-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=913607, encodeId=523a91360e54, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=49db1605285, createdName=yinier, createdTime=Mon Jan 04 15:22:27 CST 2021, time=2021-01-04, status=1, ipAttribution=)]
2021-01-04 ludan233

学习了

136 0
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createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLDM9swhbgTo7nzqRKzMmzckmEoeTyLQVDCgjqsicjyhxPs0vPoYU6GsSYbCjSkNHicJkz3NL0a0EbUMVdNjkctXI6FocpGKaVr9E/0, createdBy=29392048316, createdName=ms2000001051330459, createdTime=Mon Jan 11 13:49:00 CST 2021, time=2021-01-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1357636, encodeId=5edf135e636cb, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Wed Jan 06 01:04:50 CST 2021, time=2021-01-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1431991, encodeId=2dd6143199186, content=<a href='/topic/show?id=f9b9e9124a8' target=_blank style='color:#2F92EE;'>#综合征#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79124, encryptionId=f9b9e9124a8, topicName=综合征)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Wed Jan 06 01:04:50 CST 2021, time=2021-01-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1563398, encodeId=067e1563398dc, content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=81, 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=Wed Jan 06 01:04:50 CST 2021, time=2021-01-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=913895, encodeId=4175913895b1, content=禁烟很重要啊, beContent=null, objectType=article, channel=null, level=null, likeNumber=145, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200914/f1df8506d5cb4909bac2efc340b6c1fe/dcc6dd2dbec44613838b555fbe723804.jpg, createdBy=686b1371609, createdName=liyu7822, createdTime=Tue Jan 05 16:15:22 CST 2021, time=2021-01-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=913710, encodeId=c72a913e10e2, content=学习到了, beContent=null, objectType=article, channel=null, level=null, likeNumber=157, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8db85450012, createdName=ms4000000529616129, createdTime=Mon Jan 04 21:20:57 CST 2021, time=2021-01-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=913682, encodeId=f88f91368275, content=吸烟有害健康, beContent=null, objectType=article, channel=null, level=null, likeNumber=135, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b2b82397018, createdName=12346c4dm64暂无昵称, createdTime=Mon Jan 04 19:29:56 CST 2021, time=2021-01-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=913636, encodeId=d16c91363639, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=136, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ae605445021, createdName=ludan233, createdTime=Mon Jan 04 17:26:53 CST 2021, time=2021-01-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=913607, encodeId=523a91360e54, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=49db1605285, createdName=yinier, createdTime=Mon Jan 04 15:22:27 CST 2021, time=2021-01-04, status=1, ipAttribution=)]
2021-01-04 yinier

学习了

64 0

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