鱼精蛋白不会增加择期颈动脉支架置入术患者的中风风险。
Protamine does not increase risk of stroke in patients with elective carotid stenting.
机构信息
Department of Radiology, Mayo Clinic, Rochester, MN 55905, USA.
出版信息
Stroke. 2013 Jul;44(7):2028-30. doi: 10.1161/STROKEAHA.113.001188. Epub 2013 Jun 11.
BACKGROUND AND PURPOSE
Reversal of anticoagulation with protamine might predispose to a higher risk of stroke in patients with carotid stenting. We evaluated a national, multihospital patient database to examine the risk of stroke in patients with carotid stenting receiving protamine compared with those who did not.
METHODS
The Premier Perspective database was used to identify patients who were electively hospitalized for carotid stenting from 2006 through 2011. The incidence of in-hospital mortality and morbidity was compared between patients who did and did not receive protamine after propensity score adjustment via 1:1 matching to reduce selection bias.
RESULTS
Of 6664 patients with carotid stenting treated at 193 hospitals, 556 (8%) received protamine on the day of the procedure. After matching by propensity score, patients who received protamine had a similar likelihood of stroke or transient ischemic attack (P=0.77), in-hospital mortality (P=0.12), discharge to long-term care (P=0.15), and access site complications (P=0.90) as compared with patients who did not receive protamine.
CONCLUSIONS
Protamine administration is not associated with additional risk of adverse events after carotid stenting.
背景与目的
使用鱼精蛋白逆转抗凝可能会使颈动脉支架置入患者发生中风的风险更高。我们评估了一个全国性的多医院患者数据库，以检查接受鱼精蛋白治疗的颈动脉支架置入患者与未接受鱼精蛋白治疗的患者中风的风险。
方法
使用 Premier Perspective 数据库，从 2006 年至 2011 年，确定了因颈动脉支架置入而择期住院的患者。通过倾向评分 1:1 匹配进行调整，以减少选择偏差，比较了接受和未接受鱼精蛋白治疗的患者的住院死亡率和发病率。
结果
在 193 家医院接受颈动脉支架置入治疗的 6664 例患者中，556 例（8%）在手术当天接受了鱼精蛋白。通过倾向评分匹配后，与未接受鱼精蛋白治疗的患者相比，接受鱼精蛋白治疗的患者中风或短暂性脑缺血发作（P=0.77）、住院期间死亡率（P=0.12）、长期护理出院（P=0.15）和入路部位并发症（P=0.90）的可能性相似。
结论
与未接受鱼精蛋白治疗的患者相比，颈动脉支架置入术后使用鱼精蛋白并不会增加不良事件的风险。
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