主页 > 医药生命 >
【文摘发布】急性冠脉综合征行PCI时单独应用比
Author： Gregg W Stone,Harvey D White, Magnus Ohman, Michel E Bertrand , Michael Lincoff, Brent T McLaurin, David A Cox , Stuart J Pocock, James H Ware , Frederick Feit, Antonio Colombo , Steven V Manoukian , Alexandra J Lansky ,
Resource:The Lancet 2007; 369:907-919
Abstract：Background：The aim of this study was to assess anticoagulation with the direct thrombin inhibitor bivalirudin during percutaneous coronary intervention in individuals with moderate and high-risk acute coronary syndromes.Methods：
13 819 individuals in the Acute Catheterization and Urgent Intervention Triage strategy (ACUITY) trial were prospectively randomly assigned to receive heparin (unfractionated or enoxaparin) plus glycoprotein IIb/IIIa inhibitors, bivalirudin plus glycoprotein IIb/IIIa inhibitors, or bivalirudin alone. Of these individuals, 7789 underwent percutaneous coronary intervention after angiography. The effect of the three regimens on the primary 30-day endpoints of composite ischaemia (death, myocardial infarction, or unplanned revascularisation for ischaemia), major bleeding, and net clinical outcomes (composite ischaemia or major bleeding) was assessed in this subgroup. Analyses were done by intention to treat. This trial is registered with ClinicalTrials.gov, with the number NCT00093158.Findings：Of the individuals who underwent percutaneous coronary intervention, 2561 received heparin plus glycoprotein IIb/IIIa inhibitors, 2609 received bivalirudin plus glycoprotein IIb/IIIa inhibitors, and 2619 received bivalirudin alone. 26 (0·3%) individuals dropped out or were lost to follow-up. There was no significant difference in the proportion of individuals with composite ischaemia, major bleeding, or net clinical outcomes at 30 days between those who received bivalirudin plus glycoprotein IIb/IIIa inhibitors and those who received heparin plus glycoprotein IIb/IIIa inhibitors (composite ischaemia: 243 [9%] patients vs 210 [8%] patients, p=0·16; major bleeding: 196 [8%] patients vs 174 [7%] patients, p=0·32; net clinical outcomes: 389 [15%] patients vs 341 [13%] patients, p=0·1). Rates of composite ischaemia were much the same in those who received bivalirudin alone and those who received heparin plus glycoprotein IIb/IIIa inhibitors (230 [9%] patients vs 210 [8%] patients, p=0·45); however, there were significantly fewer individuals who experienced major bleeding among those who received bivalirudin alone than among those who received heparin plus glycoprotein IIb/IIIa inhibitors (92 [4%] patients vs 174 [7%] patients, p<0·0001, relative risk 0·52, 95% CI 0·40–0·66), resulting in a trend towards better 30-day net clinical outcomes (303 [12%] patients vs 341 [13%] patients, p=0·057; 0·87, 0·75–1·00).Interpretation：Substitution of unfractionated heparin or enoxaparin with bivalirudin results in comparable clinical outcomes in patients with moderate and high-risk acute coronary syndromes treated with glycoprotein IIb/IIIa inhibitors in whom percutaneous coronary intervention is done. Anticoagulation with bivalirudin alone suppresses adverse ischaemic events to a similar extent as does heparin plus glycoprotein IIb/IIIa inhibitors, while significantly lowering the risk of major haemorrhagic complications. 本人已认领该文编译，48小时后若未提交译文，请其他战友自由认领。 Title：Bivalirudin in patients with acute coronary syndromes undergoing percutaneous coronary intervention: a subgroup analysis from the Acute Catheterization and Urgent Intervention Triage strategy (ACUITY) trial
标题：比伐芦定在急性冠脉综合征患者经皮冠脉介入治疗中的应用 紧急导管置入和急诊介入分类治疗策略（AUITY）试验亚组分析
Author： Gregg W Stone,Harvey D White, Magnus Ohman, Michel E Bertrand , Michael Lincoff, Brent T McLaurin, David A Cox , Stuart J Pocock, James H Ware , Frederick Feit, Antonio Colombo , Steven V Manoukian , Alexandra J Lansky ,
Resource:The Lancet 2007; 369:907-919
来源：《柳叶刀》2007; 369:907-919
Abstract：
摘要：
Background：The aim of this study was to assess anticoagulation with the direct thrombin inhibitor bivalirudin during percutaneous coronary intervention in individuals with moderate and high-risk acute coronary syndromes.
背景：本研究旨在评价直接凝血酶抑制剂比伐芦定在急性冠脉综合征中高危患者行经皮介入治疗（PCI）中的抗凝效果。
Methods：13 819 individuals in the Acute Catheterization and Urgent Intervention Triage strategy (ACUITY) trial were prospectively randomly assigned to receive heparin (unfractionated or enoxaparin) plus glycoprotein IIb/IIIa inhibitors, bivalirudin plus glycoprotein IIb/IIIa inhibitors, or bivalirudin alone. Of these individuals, 7789 underwent percutaneous coronary intervention after angiography. The effect of the three regimens on the primary 30-day endpoints of composite ischaemia (death, myocardial infarction, or unplanned revascularisation for ischaemia), major bleeding, and net clinical outcomes (composite ischaemia or major bleeding) was assessed in this subgroup. Analyses were done by intention to treat. This trial is registered with ClinicalTrials.gov, with the number NCT00093158.
阅读本文的人还阅读：
作者:admin@医学,生命科学 2011-05-28 17:11
医学,生命科学网