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减少急性冠状动脉综合征患者中与阿昔单抗相关出血的试点干预措施的有效性。

Effectiveness of a pilot intervention to reduce abciximab-related bleeding in patients with acute coronary syndromes.

机构信息

Pharmacy Department, Instituto de Investigación Sanitaria Gregorio Marañón, Hospital General Universitario Gregorio Marañón, C/Doctor Esquerdo 46, 28007, Madrid, Spain,

出版信息

Int J Clin Pharm. 2014 Aug;36(4):821-6. doi: 10.1007/s11096-014-9972-3. Epub 2014 Jun 20.

Abstract

BACKGROUND AND OBJECTIVE

Reducing bleeding events is a priority in patients diagnosed with acute coronary syndromes (ACS). The effectiveness of optimization measures for reducing abciximab-related bleeding was evaluated through the implementation of a pilot program developed by the Pharmacy and the Cardiology Departments at a tertiary-care hospital.

MAIN OUTCOME MEASURE

Percentage of bleeding events.

RESULTS

Intervention was effective in reducing the incidence of the three factors associated with an increased risk of bleeding between the pre-intervention phase (n = 86) and the post-intervention phase (n = 73): unknown body weight (24.4 vs. 1.4 %, p = 0.0001), overdosing (31.4 vs. 0 %, p < 0.0001) and combination with bivalirudin (12.8 vs. 1.4 %, p = 0.016). Bleeding events associated with these factors were numerically reduced in all three cases but these differences were not statistically significant between both periods.

CONCLUSION

The implementation of a multidisciplinary prevention program can reduce situations associated with an increased risk of bleeding in patients treated with abciximab. Larger scale trials are needed to confirm whether such programs can also reduce the incidence of bleeding at a statistically significant level.

摘要

背景和目的

减少出血事件是急性冠状动脉综合征(ACS)患者的首要任务。通过在三级保健医院的药房和心脏病科实施试点计划,评估了减少阿昔单抗相关出血的优化措施的效果。

主要观察指标

出血事件的百分比。

结果

干预措施有效降低了三个与出血风险增加相关因素的发生率,包括干预前阶段(n=86)和干预后阶段(n=73):未知体重(24.4%比1.4%,p=0.0001)、用药过量(31.4%比0%,p<0.0001)和与比伐卢定联合使用(12.8%比1.4%,p=0.016)。在所有三种情况下,与这些因素相关的出血事件在数值上都有所减少,但在两个时期之间,这些差异没有统计学意义。

结论

实施多学科预防计划可以减少接受阿昔单抗治疗的患者出血风险增加的情况。需要更大规模的试验来证实此类计划是否也可以在统计学上显著降低出血发生率。

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