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Stroke:既往抗血小板治疗与卒中后颅内出血引发的死亡相关?

2017-07-06 易湛苗 环球医学资讯

2017年发表在《Stroke》的一项由加拿大科学家进行的研究,考察了既往使用抗血小板药物治疗(APT)与颅内出血(ICH)死亡风险的相关性。

2017年发表在《Stroke》的一项由加拿大科学家进行的研究,考察了既往使用抗血小板药物治疗(APT)与颅内出血(ICH)死亡风险的相关性。

背景和目的:尽管使用APT与ICH的风险相关,但卒中前使用APT和结局关系的数据有限,尤其是使用联合APT(CAPT)治疗的患者中。研究人员假设既往使用抗血小板药物与ICH死亡率增加相关。

方法:研究人员分析了2012年10月~2016年3月,1574家“遵循卒中指南”研究的医院中,82576名未口服抗血小板药物治疗的ICH患者的数据。患者在医院诊断为ICH之前,按未用APT、仅用APT(SAPT)和CAPT分类。研究人员描述患者基线特征、合并症、医院特征和结局,按APT使用情况进行综合与分层。

结果:在ICH诊断前,有65.8%的患者不用APT,29.5%的患者用SAPT,4.8%的患者用CAPT。与无APT组相比,APT组的院内死亡率总体上轻度升高(24% vs 23%;调整比值比,1.05;95%置信区间[CI],1.01~1.10)。尽管SAPT和CAPT的患者年龄更大,且在并发症方面风险更大,但SAPT组vs无任何APT组的院内死亡率无明显差异(23% vs 23%;调整比值比,1.01;95%CI,0.97~1.05)。然而,CAPT组比无APT组的院内死亡率增高(30% vs 23%;调整比值比,1.05;95%CI,1.39~1.63)。

结论:研究表明,在ICH患者中,既往使用CAPT而不是SAPT,与较高的院内死亡率风险相关。

原始出处
Khan NI, Siddiqui FM, Goldstein JN, et al. Association Between Previous Use of Antiplatelet Therapy and Intracerebral Hemorrhage Outcomes.Stroke. 2017 Jul;48(7):1810-1817. doi: 10.1161/STROKEAHA.117.016290. Epub 2017 Jun 8.

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  2. [GetPortalCommentsPageByObjectIdResponse(id=1671302, encodeId=401d16e130261, content=<a href='/topic/show?id=9f4e360191a' target=_blank style='color:#2F92EE;'>#卒中后#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=36019, encryptionId=9f4e360191a, topicName=卒中后)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ff7426824786, createdName=waiwai3039, createdTime=Mon Sep 18 02:53:00 CST 2017, time=2017-09-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=220864, encodeId=d44922086408, content=文章真好,拜读了, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Tue Jul 11 06:39:41 CST 2017, time=2017-07-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=219829, encodeId=582a21982970, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=445f1740270, createdName=meiliwuxian, createdTime=Sat Jul 08 08:06:03 CST 2017, time=2017-07-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=219289, encodeId=819d219289df, content=这样的比较参考选择有讲究, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLCclExeQ6LOGMD4dTsia4Ty4HtZCxRmG5vO5XIKfKX3a3vusfhHSej4Iib517vmhFW7RQgh7bpDp1yw/0, createdBy=50951609779, createdName=baihao215, createdTime=Thu Jul 06 23:31:25 CST 2017, time=2017-07-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=219212, encodeId=25c4219212b0, content=学习了分享了, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=387d1660055, createdName=dhzzm, createdTime=Thu Jul 06 18:04:03 CST 2017, time=2017-07-06, status=1, ipAttribution=)]
    2017-07-11 1e10c84am36(暂无匿称)

    文章真好,拜读了

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=1671302, encodeId=401d16e130261, content=<a href='/topic/show?id=9f4e360191a' target=_blank style='color:#2F92EE;'>#卒中后#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=36019, encryptionId=9f4e360191a, topicName=卒中后)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ff7426824786, createdName=waiwai3039, createdTime=Mon Sep 18 02:53:00 CST 2017, time=2017-09-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=220864, encodeId=d44922086408, content=文章真好,拜读了, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Tue Jul 11 06:39:41 CST 2017, time=2017-07-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=219829, encodeId=582a21982970, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=445f1740270, createdName=meiliwuxian, createdTime=Sat Jul 08 08:06:03 CST 2017, time=2017-07-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=219289, encodeId=819d219289df, content=这样的比较参考选择有讲究, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLCclExeQ6LOGMD4dTsia4Ty4HtZCxRmG5vO5XIKfKX3a3vusfhHSej4Iib517vmhFW7RQgh7bpDp1yw/0, createdBy=50951609779, createdName=baihao215, createdTime=Thu Jul 06 23:31:25 CST 2017, time=2017-07-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=219212, encodeId=25c4219212b0, content=学习了分享了, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=387d1660055, createdName=dhzzm, createdTime=Thu Jul 06 18:04:03 CST 2017, time=2017-07-06, status=1, ipAttribution=)]
    2017-07-08 meiliwuxian

    学习了

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=1671302, encodeId=401d16e130261, content=<a href='/topic/show?id=9f4e360191a' target=_blank style='color:#2F92EE;'>#卒中后#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=36019, encryptionId=9f4e360191a, topicName=卒中后)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ff7426824786, createdName=waiwai3039, createdTime=Mon Sep 18 02:53:00 CST 2017, time=2017-09-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=220864, encodeId=d44922086408, content=文章真好,拜读了, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Tue Jul 11 06:39:41 CST 2017, time=2017-07-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=219829, encodeId=582a21982970, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=445f1740270, createdName=meiliwuxian, createdTime=Sat Jul 08 08:06:03 CST 2017, time=2017-07-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=219289, encodeId=819d219289df, content=这样的比较参考选择有讲究, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLCclExeQ6LOGMD4dTsia4Ty4HtZCxRmG5vO5XIKfKX3a3vusfhHSej4Iib517vmhFW7RQgh7bpDp1yw/0, createdBy=50951609779, createdName=baihao215, createdTime=Thu Jul 06 23:31:25 CST 2017, time=2017-07-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=219212, encodeId=25c4219212b0, content=学习了分享了, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=387d1660055, createdName=dhzzm, createdTime=Thu Jul 06 18:04:03 CST 2017, time=2017-07-06, status=1, ipAttribution=)]
    2017-07-06 baihao215

    这样的比较参考选择有讲究

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=1671302, encodeId=401d16e130261, content=<a href='/topic/show?id=9f4e360191a' target=_blank style='color:#2F92EE;'>#卒中后#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=36019, encryptionId=9f4e360191a, topicName=卒中后)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ff7426824786, createdName=waiwai3039, createdTime=Mon Sep 18 02:53:00 CST 2017, time=2017-09-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=220864, encodeId=d44922086408, content=文章真好,拜读了, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Tue Jul 11 06:39:41 CST 2017, time=2017-07-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=219829, encodeId=582a21982970, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=445f1740270, createdName=meiliwuxian, createdTime=Sat Jul 08 08:06:03 CST 2017, time=2017-07-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=219289, encodeId=819d219289df, content=这样的比较参考选择有讲究, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLCclExeQ6LOGMD4dTsia4Ty4HtZCxRmG5vO5XIKfKX3a3vusfhHSej4Iib517vmhFW7RQgh7bpDp1yw/0, createdBy=50951609779, createdName=baihao215, createdTime=Thu Jul 06 23:31:25 CST 2017, time=2017-07-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=219212, encodeId=25c4219212b0, content=学习了分享了, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=387d1660055, createdName=dhzzm, createdTime=Thu Jul 06 18:04:03 CST 2017, time=2017-07-06, status=1, ipAttribution=)]
    2017-07-06 dhzzm

    学习了分享了

    0

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