Int J Cardiol:主动脉瓣狭窄患者心肌梗死后双重抗血小板治疗的相关结果

2019-01-20 xing.T MedSci原创

由此可见,当采用DAPT治疗时,AS与MI后出血、复发性心肌梗死和死亡率风险增加有关。在这个高危人群中,可能需要个体化选择抗血小板治疗。

获得性最大血管性血友病因子多聚体的丢失是主动脉瓣狭窄(AS)患者常见的止血障碍,导致血小板粘连受损和出血风险增加。AS还与动脉粥样硬化和心肌梗塞(MI)有关。近日,血管领域权威杂志International Journal of Cardiology上发表了一篇研究文章,研究人员的目的是在全国范围的医院登记研究中探究接受双重抗血小板治疗(DAPT)的MI患者与AS相关的临床结局。

以瑞典(2005-2010)和丹麦(2005-2015)的全国医院出院登记中心为基础,研究人员计算了接受DAPT的伴有和不伴有AS的MI患者出血、复发性MI和全因死亡率的1年发病率和风险比。两个国家的结果也合并在一项荟萃分析中。

研究人员收集了来自瑞典的50460名MI患者和来自丹麦的50307名MI患者,其中3%的参与者患有AS。瑞典和丹麦的出血率(每100人每年)在没有AS的患者中分别为3.2和3.3,而在AS患者中分别为9.2和8.3。瑞典伴有和不伴有AS参与者的全因死亡率分别为7.1和28.7,丹麦分别为5.8和30.7。 AS患者出血、复发性心肌梗死和全因死亡风险增加。两国的复合结果相似,对于出血(风险比为1.59 [0.98-2.59])、复发MI(1.78 [1.25-2.54])和全因死亡率(1.76 [1.26-2.47])。

由此可见,当采用DAPT治疗时,AS与MI后出血、复发性心肌梗死和死亡率风险增加有关。在这个高危人群中,可能需要个体化选择抗血小板治疗。

原始出处:

AndreasMartinsson,et al.Outcomes associated with dual antiplatelet therapy after myocardial infarction in patients with aortic stenosis.International Journal of Cardiology.2019.https://doi.org/10.1016/j.ijcard.2019.01.063

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