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普拉格雷用于长期临床实践中的日本缺血性心脏病患者(PRASFIT-实践 II)-上市后观察性研究的 3 个月中期分析。

Prasugrel for Japanese Patients With Ischemic Heart Disease in Long-Term Clinical Practice (PRASFIT-Practice II) - A 3-Month Interim Analysis of a Postmarketing Observational Study.

机构信息

Division of Cardiovascular Medicine, Toho University Ohashi Medical Center.

Division of Cardiology, Department of Internal Medicine, Teikyo University.

出版信息

Circ J. 2019 Feb 25;83(3):637-646. doi: 10.1253/circj.CJ-18-0956. Epub 2019 Jan 24.

Abstract

BACKGROUND

A unique dose of prasugrel has been approved exclusively for Japanese patients, but real-world data for prasugrel at that dose in patients with ischemic heart disease (IHD) are limited. Therefore, large-scale, real-world data are needed.

METHODS AND RESULTS

A 2-year observational study of Japanese patients with IHD undergoing percutaneous coronary intervention and being treated with prasugrel to evaluate safety and effectiveness. This report is an interim analysis of data from case report forms (CRFs) after 3 months. CRFs were collected from 4,270 patients, 4,157 of whom were eligible for the safety and effectiveness analysis sets (mean age, 68.3 years; male, 76.5%). The median treatment period was 112 days, and 92.3% of patients continued treatment with prasugrel. The incidence of non-coronary artery bypass grafting-related bleeding adverse events (AEs) was 3.1%, of which Thrombolysis in Myocardial Infarction (TIMI) major and minor bleeding accounted for 0.5% and 0.6%, respectively. The most common bleeding AEs were gastrointestinal disorders, which accounted for 43.2% of the sum of "TIMI major and minor bleeding AEs". The incidence of major adverse cardiovascular events (MACE) was 1.0%, and the cumulative incidence of MACE was 1.4%. The incidence of stent thrombosis was 0.2%.

CONCLUSIONS

Interim study results indicated that prasugrel was safe and effective during the early phase of treatment in Japanese patients with IHD in real-world clinical settings.

摘要

背景

一种独特剂量的普拉格雷仅被批准用于日本患者,但在缺血性心脏病(IHD)患者中使用该剂量的普拉格雷的真实世界数据有限。因此,需要大规模的真实世界数据。

方法和结果

一项为期 2 年的观察性研究,纳入了接受经皮冠状动脉介入治疗并接受普拉格雷治疗的 IHD 日本患者,旨在评估安全性和有效性。本报告是对 3 个月后病例报告表(CRF)数据的中期分析。从 4270 名患者中收集了 CRF,其中 4157 名符合安全性和有效性分析集的条件(平均年龄 68.3 岁;男性 76.5%)。中位治疗期为 112 天,92.3%的患者继续接受普拉格雷治疗。非冠状动脉旁路移植术相关出血不良事件(AE)的发生率为 3.1%,其中血栓溶解心肌梗死(TIMI)大出血和小出血分别占 0.5%和 0.6%。最常见的出血 AE 是胃肠道疾病,占 TIMI 大出血和小出血之和的 43.2%。主要不良心血管事件(MACE)的发生率为 1.0%,MACE 的累积发生率为 1.4%。支架血栓形成的发生率为 0.2%。

结论

中期研究结果表明,在真实世界临床环境中,普拉格雷在 IHD 日本患者的早期治疗阶段是安全有效的。

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