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在接受经皮冠状动脉介入治疗的急性冠状动脉综合征患者中使用坎格雷洛:ARCANGELO 研究的研究设计和中期分析。

Use of cangrelor in patients with acute coronary syndromes undergoing percutaneous coronary intervention: Study design and interim analysis of the ARCANGELO study.

机构信息

Department of Cardiosciences, Division of Cardiology, Azienda Ospedaliera San Camillo-Forlanini, Rome, Italy.

U.O.C. Cardiologia Clinica con UTIC. A.O.R.N. Sant'Anna e San Sebastiano, Caserta, Italy.

出版信息

Clin Cardiol. 2022 Sep;45(9):913-920. doi: 10.1002/clc.23878. Epub 2022 Jun 22.

Abstract

BACKGROUND

The itAlian pRospective Study on CANGrELOr (ARCANGELO) was aimed to assess the safety of using cangrelor during percutaneous coronary intervention (PCI) in patients with acute coronary syndromes (ACS) in the daily practice.

HYPOTHESIS

The safety of cangrelor after the transition to oral P2Y12 inhibitors was evaluated as the incidence of bleeding outcomes in the 30 days following PCI according to postauthorization safety study guidelines.

METHODS

Adults with ACS who were treated with cangrelor in one of the 28 centers involved in the study. Patients who consented to participate were followed in the 30 days following their PCI. Bleedings (Bleeding Academic Research Consortium [BARC] classification), major adverse cardiac events (MACEs), and adverse events were recorded. The interim results at two-thirds of the enrollment period are presented.

RESULTS

A total of 17 bleedings were observed in the 320 patients who completed the study at this stage. All bleedings were classified as BARC Type 1-2, except for one case of Type 3a (vessel puncture site hematoma). Four patients experienced MACEs (2 acute myocardial infarctions, 1 sudden cardiac death, 1 noncardiovascular death due to respiratory distress, and multiorgan failure). None of the bleedings was rated as related to cangrelor.

CONCLUSIONS

The interim results of the ARCANGELO study provide a preliminary confirmation that the use of cangrelor on patients with ACS undergoing PCI is not associated with severe bleedings.

摘要

背景

意大利前瞻性研究 CANGrELOr(ARCANGELO)旨在评估在急性冠脉综合征(ACS)患者中经皮冠状动脉介入治疗(PCI)期间使用坎格雷洛的安全性,这是在日常实践中的应用。

假说

根据上市后安全性研究指南,评估 PCI 后转为口服 P2Y12 抑制剂时坎格雷洛的安全性,即 PCI 后 30 天内出血结局的发生率。

方法

在参与研究的 28 个中心之一接受坎格雷洛治疗的 ACS 成年患者。同意参与的患者在 PCI 后 30 天内进行随访。记录出血(出血学术研究联合会[BARC]分类)、主要不良心脏事件(MACEs)和不良事件。目前呈现的是在登记期三分之二时的中期结果。

结果

在完成研究的 320 名患者中,共观察到 17 例出血。所有出血均归类为 BARC 1-2 型,除了 1 例 3a 型(血管穿刺部位血肿)。4 名患者发生 MACEs(2 例急性心肌梗死、1 例心源性猝死、1 例非心血管性死亡归因于呼吸困难和多器官功能衰竭)。没有出血被评为与坎格雷洛相关。

结论

ARCANGELO 研究的中期结果初步证实,在接受 PCI 的 ACS 患者中使用坎格雷洛不会导致严重出血。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e22a/9451664/dc5f15c9e303/CLC-45-913-g002.jpg

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