当前位置:循环首页>正文

ACUITY试验:非ST段抬高型急性冠脉综合征中高龄、抗栓治疗策略与出血的关系

Advanced age, antithrombotic strategy, and bleeding in non-ST-segment elevation acute coronary syndromes: results from the ACUITY (Acute Catheterization and Urgent Intervention Triage Strategy) trial.

作者:国际循环网   日期:2010/12/14 10:02:33

国际循环网版权所有,谢绝任何形式转载,侵犯版权者必予法律追究。

Lopes RD, Alexander KP, Manoukian SV, Bertrand ME, Feit F, White HD, Pollack CV Jr, Hoekstra J, Gersh BJ, Stone GW, Ohman EM.

    Lopes RD, Alexander KP, Manoukian SV, Bertrand ME, Feit F, White HD, Pollack CV Jr, Hoekstra J, Gersh BJ, Stone GW, Ohman EM.
    Duke University Medical Center, Durham, North Carolina, USA. renato.lopes@duke.edu
Abstract
    OBJECTIVES: This study sought to evaluate the impact of age on outcomes in patients with moderate- and high-risk non-ST-segment elevation acute coronary syndrome (NSTE-ACS) enrolled in the ACUITY (Acute Catheterization and Urgent Intervention Triage Strategy) trial.
    BACKGROUND: Aging-associated changes in physiology and metabolism may alter the risk and benefit of therapeutic strategies from that observed in younger people.
    METHODS: We performed a pre-specified analysis of 30-day and 1-year outcomes in 4 age groups, overall and among those undergoing percutaneous coronary intervention (PCI).
    RESULTS: Of 13,819 patients in the ACUITY trial, 3,655 (26.4%) were <55 years of age, 3,940 (28.5%) were 55 to 64 years of age, 3,783 (27.4%) were 65 to 74 years of age, and 2,441 (17.7%) were > or =75 years of age. Older patients had more cardiovascular risk factors and had a higher acuity at presentation. Patients age > or =75 years treated with bivalirudin alone had similar ischemic outcomes, but significantly lower rates of bleeding compared with those treated with heparin and glycoprotein IIb/IIIa inhibitors overall and in the PCI subset. The number needed to treat with bivalirudin alone to avoid 1 major bleeding event was lower in this age group (23 overall and 16 for PCI-treated patients) than in any other.
CONCLUSIONS: Ischemic and bleeding complications after NSTE-ACS increase with age. Although ischemic event rates are not statistically different with either bivalirudin alone or a heparin plus glycoprotein IIb/IIIa inhibitor, bleeding complications are significantly less frequent with bivalirudin alone. Because of the substantial risk of bleeding in patients age > or =75 years, the number needed to treat to avoid 1 major bleeding event using bivalirudin alone was the lowest in the elderly group, especially among those undergoing PCI.

 

版面编辑:沈会会  责任编辑:张衡



ACUITY非ST段抬高型急性冠脉综合征高龄抗栓治疗出血

分享到: 更多


设为首页 | 加入收藏 | 关于我们 | 联系方式 | 招贤纳士
声明:国际循环网( www.icirculation.com)对刊载的所有文章、视频、幻灯、音频等资源拥有全部版权。未经本站许可,不得转载。
京ICP备15014970号-5  互联网药品信息服务资格证书编号(京)-非经营性-2017-0063  京公网安备 11010502033353号  增值电信业务经营许可证:京ICP证150541号
国际循环 版权所有   © 2004-2024 www.icirculation.com All Rights Reserved
公司名称:北京美赞广告有限公司 公司地址:北京市朝阳区朝阳门北大街乙12号天辰大厦1座1409 电话:010-51295530