Eur Heart J:冠脉支架类型和双重抗血小板治疗的长度对缺血性和出血性事件的影响

2017-08-19 xiangting MedSci原创

不论DAPT长度如何,耐久性和可生物降解的聚合物支架与BRS的MACE比率相似。

药物洗脱支架的类型(耐用的聚合物支架[DES]vs.生物可降解聚合物支架vs.生物可吸收支架(BRS)]和双重抗血小板治疗(DAPT)长度对缺血和出血性事件的差异性影响仍有待研究。

纳入比较不同类型的DES和/或DAPT持续时间的随机对照试验。主要终点是主要不良心血管事件(MACE)[死亡、心肌梗塞(MI)和靶血管血运重建的复合]。明确的支架血栓(ST)和MACE的单一成分是次要终点。分组分别是:12个月DAPT(12mDAPT)的BRS,12mDAPT的生物降解聚合物支架,具有12mDAPT的耐用的聚合物支架[依维莫司洗脱(EES),唑罗莫司洗脱(ZES)],<12个月DAPT的EES/ZES和> 12个月DAPT 的EES/ZES。共纳入了64项研究,共有150个分组和102735例患者。经过20个月的中位随访后,MACE率在不同组间相似。DAPT>12个月的EES/ZES心梗发生率低于其他组,而BRS与EES/ZES相比,无论DAPT长度如何均显示出较高的ST比率。与较短的DAPT相比,DAPT> 12m时的大出血风险较高。

不管DAPT长度如何,耐久性和可生物降解的聚合物支架与BRS的MACE比率相似。DAPT> 12个月的EES/ZES较少出现MI,而与EES / ZES相比,不管DAPT长度如何,BRS的ST比率较高。支架类型可能与DAPT长度一起对预后产生部分影响。

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CST 2017, time=2017-08-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=235250, encodeId=70b92352507a, content=学习了谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5Kzuf9u71gZhPYMiajRtENwicoAABeQtfXOlic8ibhYSy6DvJZWUDVtjRvTfqBffr1XJ6JLtFB5kHicthl/0, createdBy=08bb2061153, createdName=189****7206, createdTime=Sun Aug 20 06:34:04 CST 2017, time=2017-08-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=235160, encodeId=358b23516060, content=学习了受益匪浅。, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLDicHg2ldsSNmib46PmdzpO7CQEmPjuULp1v45zPWwMYhrnXgvl3OtmUCZSQfgITWn96X9moL94nUGA/0, createdBy=28072041016, createdName=131****1460, createdTime=Sat Aug 19 19:58:06 CST 2017, time=2017-08-19, status=1, ipAttribution=)]
    2017-08-21 zhaojie88
  5. 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  6. 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CST 2017, time=2017-08-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=235250, encodeId=70b92352507a, content=学习了谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5Kzuf9u71gZhPYMiajRtENwicoAABeQtfXOlic8ibhYSy6DvJZWUDVtjRvTfqBffr1XJ6JLtFB5kHicthl/0, createdBy=08bb2061153, createdName=189****7206, createdTime=Sun Aug 20 06:34:04 CST 2017, time=2017-08-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=235160, encodeId=358b23516060, content=学习了受益匪浅。, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLDicHg2ldsSNmib46PmdzpO7CQEmPjuULp1v45zPWwMYhrnXgvl3OtmUCZSQfgITWn96X9moL94nUGA/0, createdBy=28072041016, createdName=131****1460, createdTime=Sat Aug 19 19:58:06 CST 2017, time=2017-08-19, status=1, ipAttribution=)]
    2017-08-21 slcumt
  7. 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    2017-08-20 三生有幸9135

    学习一下谢谢分享

    0

  8. 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createdBy=66ec123, createdName=guihongzh, createdTime=Sat Apr 21 22:56:00 CST 2018, time=2018-04-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2046336, encodeId=70ae204633626, content=<a href='/topic/show?id=5da531455b9' target=_blank style='color:#2F92EE;'>#出血性事件#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31455, encryptionId=5da531455b9, topicName=出血性事件)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7460166, createdName=zhang92560, createdTime=Sat Sep 02 11:56:00 CST 2017, time=2017-09-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1356478, encodeId=9b8f13564e86a, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, 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encodeId=b1e615626e1fb, content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, 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=Mon Aug 21 07:56:00 CST 2017, time=2017-08-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=235288, encodeId=1d02235288d1, content=学习一下谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzaiabIFicf63hKvVMjL6aJlx4yX4UcXmzX9DyibCRcicq0QtCRWMaQKh8MYjE1D3EKUBopgiaGWYuqbeR/0, createdBy=0c2b1999806, createdName=三生有幸9135, createdTime=Sun Aug 20 07:07:05 CST 2017, time=2017-08-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=235250, encodeId=70b92352507a, content=学习了谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5Kzuf9u71gZhPYMiajRtENwicoAABeQtfXOlic8ibhYSy6DvJZWUDVtjRvTfqBffr1XJ6JLtFB5kHicthl/0, createdBy=08bb2061153, createdName=189****7206, createdTime=Sun Aug 20 06:34:04 CST 2017, time=2017-08-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=235160, encodeId=358b23516060, content=学习了受益匪浅。, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLDicHg2ldsSNmib46PmdzpO7CQEmPjuULp1v45zPWwMYhrnXgvl3OtmUCZSQfgITWn96X9moL94nUGA/0, createdBy=28072041016, createdName=131****1460, createdTime=Sat Aug 19 19:58:06 CST 2017, time=2017-08-19, status=1, ipAttribution=)]
    2017-08-20 189****7206

    学习了谢谢分享

    0

  9. 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createdBy=66ec123, createdName=guihongzh, createdTime=Sat Apr 21 22:56:00 CST 2018, time=2018-04-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2046336, encodeId=70ae204633626, content=<a href='/topic/show?id=5da531455b9' target=_blank style='color:#2F92EE;'>#出血性事件#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31455, encryptionId=5da531455b9, topicName=出血性事件)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7460166, createdName=zhang92560, createdTime=Sat Sep 02 11:56:00 CST 2017, time=2017-09-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1356478, encodeId=9b8f13564e86a, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Mon Aug 21 07:56:00 CST 2017, time=2017-08-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1402168, encodeId=1c7b1402168bc, content=<a href='/topic/show?id=26163e63362' target=_blank style='color:#2F92EE;'>#双重抗血小板治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37633, encryptionId=26163e63362, topicName=双重抗血小板治疗)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTL6ka7cRR8xsokbAYjhg0mZeBm79vHeyXiaMibkYndHaibgmfg1JDA0AXlGaY8Og4IiaREUFYuBwekPoQ/132, createdBy=19852392148, createdName=bioon4, createdTime=Mon Aug 21 07:56:00 CST 2017, time=2017-08-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1562671, encodeId=b1e615626e1fb, content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, 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=Mon Aug 21 07:56:00 CST 2017, time=2017-08-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=235288, encodeId=1d02235288d1, content=学习一下谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzaiabIFicf63hKvVMjL6aJlx4yX4UcXmzX9DyibCRcicq0QtCRWMaQKh8MYjE1D3EKUBopgiaGWYuqbeR/0, createdBy=0c2b1999806, createdName=三生有幸9135, createdTime=Sun Aug 20 07:07:05 CST 2017, time=2017-08-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=235250, encodeId=70b92352507a, content=学习了谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5Kzuf9u71gZhPYMiajRtENwicoAABeQtfXOlic8ibhYSy6DvJZWUDVtjRvTfqBffr1XJ6JLtFB5kHicthl/0, createdBy=08bb2061153, createdName=189****7206, createdTime=Sun Aug 20 06:34:04 CST 2017, time=2017-08-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=235160, encodeId=358b23516060, content=学习了受益匪浅。, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLDicHg2ldsSNmib46PmdzpO7CQEmPjuULp1v45zPWwMYhrnXgvl3OtmUCZSQfgITWn96X9moL94nUGA/0, createdBy=28072041016, createdName=131****1460, createdTime=Sat Aug 19 19:58:06 CST 2017, time=2017-08-19, status=1, ipAttribution=)]
    2017-08-19 131****1460

    学习了受益匪浅。

    0