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NEJM:高出血风险PCI患者的选择——无聚合物药物涂层支架vs聚合物药物洗脱支架

2020-02-13 MedSci MedSci原创

研究认为,对于高出血风险的PCI患者,接受聚合物佐他莫司洗脱支架与无聚合物乌米莫司涂层支架PCI在安全性和疗效方面无显著差异

无聚合物药物涂层支架是高出血风险PCI患者的临床选择,这些患者在接受经皮冠状动脉介入治疗(PCI)后需接受1个月的双重抗血小板治疗。近日研究人员考察了高出血风险患者接受聚合物药物洗脱支架PCI的效果。

研究人员比较了聚合物佐他莫司洗脱支架与无聚合物乌米莫司涂层支架对于高出血风险PCI患者的效果。在PCI后,患者接受1个月的双重抗血小板药物治疗,随后接受单一抗血小板药物治疗。研究的主要终点为心血管死亡、心肌梗死或支架血栓形成的1年复合终点。

1996名患者参与研究,其中佐他莫司洗脱支架组1003人,乌米莫司涂层支架组993人。1年后,药物洗脱支架组169名患者出现终点事件,药物涂层支架组164人(17.1% vs 16.9%,差异为0.2%,达到非劣性)。组间次要终点差异也不显著,达到非劣性。

研究认为,对于高出血风险的PCI患者,接受聚合物佐他莫司洗脱支架与无聚合物乌米莫司涂层支架PCI在安全性和疗效方面无显著差异。

原始出处:

Stephan Windecker et al. Polymer-based or Polymer-free Stents in Patients at High Bleeding Risk. N Engl J Med, February 12, 2020.

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    2020-10-31 zhmscau
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  5. [GetPortalCommentsPageByObjectIdResponse(id=1786814, encodeId=a6e51e868141c, content=<a href='/topic/show?id=f762138395a' target=_blank style='color:#2F92EE;'>#PCI患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13839, encryptionId=f762138395a, topicName=PCI患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2e94174, createdName=zhmscau, createdTime=Sat Oct 31 16:18:00 CST 2020, time=2020-10-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1998778, encodeId=73551998e7811, content=<a href='/topic/show?id=80936510423' target=_blank style='color:#2F92EE;'>#洗脱支架#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=82, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65104, encryptionId=80936510423, topicName=洗脱支架)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1e72268, createdName=zhixianchen, createdTime=Sun Nov 22 15:18:00 CST 2020, time=2020-11-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2045538, encodeId=0dfc204553818, content=<a href='/topic/show?id=33ac8080ee0' target=_blank style='color:#2F92EE;'>#聚合物药物洗脱支架#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=80807, encryptionId=33ac8080ee0, topicName=聚合物药物洗脱支架)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e1cc90, createdName=rebeccajiejie, createdTime=Mon Apr 13 17:18:00 CST 2020, time=2020-04-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1310505, encodeId=8be8131050560, content=<a href='/topic/show?id=f70e8e78941' target=_blank style='color:#2F92EE;'>#药物洗脱支架#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=80, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=87789, encryptionId=f70e8e78941, topicName=药物洗脱支架)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=86b7385, createdName=lqrandywkz, createdTime=Sat Feb 15 02:18:00 CST 2020, time=2020-02-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1519930, encodeId=51f915199309b, content=<a href='/topic/show?id=d89a102198c4' target=_blank style='color:#2F92EE;'>#高出血风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=102198, encryptionId=d89a102198c4, topicName=高出血风险)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b56911304930, createdName=陈吴1238, createdTime=Sat Feb 15 02:18:00 CST 2020, time=2020-02-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1521297, encodeId=b9b0152129e11, content=<a href='/topic/show?id=98bc80e9418' target=_blank style='color:#2F92EE;'>#聚合物#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=80794, encryptionId=98bc80e9418, topicName=聚合物)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=0bf611326764, createdName=yese, createdTime=Sat Feb 15 02:18:00 CST 2020, time=2020-02-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1035129, encodeId=a8521035129c2, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Thu Feb 13 14:18:00 CST 2020, time=2020-02-13, status=1, ipAttribution=)]
  6. [GetPortalCommentsPageByObjectIdResponse(id=1786814, encodeId=a6e51e868141c, content=<a href='/topic/show?id=f762138395a' target=_blank style='color:#2F92EE;'>#PCI患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13839, encryptionId=f762138395a, topicName=PCI患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2e94174, createdName=zhmscau, createdTime=Sat Oct 31 16:18:00 CST 2020, time=2020-10-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1998778, encodeId=73551998e7811, content=<a href='/topic/show?id=80936510423' target=_blank style='color:#2F92EE;'>#洗脱支架#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=82, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65104, encryptionId=80936510423, topicName=洗脱支架)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1e72268, createdName=zhixianchen, createdTime=Sun Nov 22 15:18:00 CST 2020, time=2020-11-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2045538, encodeId=0dfc204553818, content=<a href='/topic/show?id=33ac8080ee0' target=_blank style='color:#2F92EE;'>#聚合物药物洗脱支架#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=80807, encryptionId=33ac8080ee0, topicName=聚合物药物洗脱支架)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e1cc90, createdName=rebeccajiejie, createdTime=Mon Apr 13 17:18:00 CST 2020, time=2020-04-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1310505, encodeId=8be8131050560, content=<a href='/topic/show?id=f70e8e78941' target=_blank style='color:#2F92EE;'>#药物洗脱支架#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=80, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=87789, encryptionId=f70e8e78941, topicName=药物洗脱支架)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=86b7385, createdName=lqrandywkz, createdTime=Sat Feb 15 02:18:00 CST 2020, time=2020-02-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1519930, encodeId=51f915199309b, content=<a href='/topic/show?id=d89a102198c4' target=_blank style='color:#2F92EE;'>#高出血风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=102198, encryptionId=d89a102198c4, topicName=高出血风险)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b56911304930, createdName=陈吴1238, createdTime=Sat Feb 15 02:18:00 CST 2020, time=2020-02-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1521297, encodeId=b9b0152129e11, content=<a href='/topic/show?id=98bc80e9418' target=_blank style='color:#2F92EE;'>#聚合物#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=80794, encryptionId=98bc80e9418, topicName=聚合物)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=0bf611326764, createdName=yese, createdTime=Sat Feb 15 02:18:00 CST 2020, time=2020-02-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1035129, encodeId=a8521035129c2, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Thu Feb 13 14:18:00 CST 2020, time=2020-02-13, status=1, ipAttribution=)]
    2020-02-15 yese
  7. [GetPortalCommentsPageByObjectIdResponse(id=1786814, encodeId=a6e51e868141c, content=<a href='/topic/show?id=f762138395a' target=_blank style='color:#2F92EE;'>#PCI患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13839, encryptionId=f762138395a, topicName=PCI患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2e94174, createdName=zhmscau, createdTime=Sat Oct 31 16:18:00 CST 2020, time=2020-10-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1998778, encodeId=73551998e7811, content=<a href='/topic/show?id=80936510423' target=_blank style='color:#2F92EE;'>#洗脱支架#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=82, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65104, encryptionId=80936510423, topicName=洗脱支架)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1e72268, createdName=zhixianchen, createdTime=Sun Nov 22 15:18:00 CST 2020, time=2020-11-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2045538, encodeId=0dfc204553818, content=<a href='/topic/show?id=33ac8080ee0' target=_blank style='color:#2F92EE;'>#聚合物药物洗脱支架#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=80807, encryptionId=33ac8080ee0, topicName=聚合物药物洗脱支架)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e1cc90, createdName=rebeccajiejie, createdTime=Mon Apr 13 17:18:00 CST 2020, time=2020-04-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1310505, encodeId=8be8131050560, content=<a href='/topic/show?id=f70e8e78941' target=_blank style='color:#2F92EE;'>#药物洗脱支架#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=80, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=87789, encryptionId=f70e8e78941, topicName=药物洗脱支架)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=86b7385, createdName=lqrandywkz, createdTime=Sat Feb 15 02:18:00 CST 2020, time=2020-02-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1519930, encodeId=51f915199309b, content=<a href='/topic/show?id=d89a102198c4' target=_blank style='color:#2F92EE;'>#高出血风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=102198, encryptionId=d89a102198c4, topicName=高出血风险)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b56911304930, createdName=陈吴1238, createdTime=Sat Feb 15 02:18:00 CST 2020, time=2020-02-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1521297, encodeId=b9b0152129e11, content=<a href='/topic/show?id=98bc80e9418' target=_blank style='color:#2F92EE;'>#聚合物#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=80794, encryptionId=98bc80e9418, topicName=聚合物)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=0bf611326764, createdName=yese, createdTime=Sat Feb 15 02:18:00 CST 2020, time=2020-02-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1035129, encodeId=a8521035129c2, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Thu Feb 13 14:18:00 CST 2020, time=2020-02-13, status=1, ipAttribution=)]
    2020-02-13 旺医

    顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息

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