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抗凝治疗与抗血小板治疗的股腘动脉段血管腔内血运重建术后的临床结局:一项单中心回顾性队列研究

Clinical Outcomes after Endovascular Revascularisation of the Femoropopliteal Arterial Segment in Patients with Anticoagulant versus Antiplatelet Therapy: A Single-Centre Retrospective Cohort Study.

作者信息

Pelicon Kevin, Petek Klemen, Boc Anja, Boc Vinko, Kejžar Nataša, Vižintin Cuderman Tjaša, Blinc Aleš

机构信息

Department of Vascular Diseases, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia.

Institute of Anatomy, Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia.

出版信息

J Cardiovasc Dev Dis. 2022 Jun 30;9(7):207. doi: 10.3390/jcdd9070207.

DOI:10.3390/jcdd9070207
PMID:35877569
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9319551/
Abstract

To prevent atherothrombotic events, patients with peripheral arterial disease are typically prescribed antiplatelet therapy (APT). However, some of them receive anticoagulant therapy (ACT) due to comorbidities. Our aim was to determine possible differences in the effectiveness and safety of both treatments in patients after endovascular femoropopliteal revascularisation. We retrospectively analysed 1247 patients after successful femoropopliteal revascularisation performed in a single tertiary medical centre and classified them into the ACT or APT group, based on their prescribed treatment. The groups were characterised by descriptive statistics, and their characteristics were adjusted for confounders by propensity score matching. Effectiveness and safety outcomes were assessed within one year after revascularisation. The odds ratio for the composite outcome of all-cause death, PAD exacerbation, and major amputation due to vascular causes with ACT versus APT was 1.21 (95% CI 0.53-2.21; = 0.484). The odds ratio for major bleeding as defined by the International Society on Thrombosis and Haemostasis with ACT versus APT was 0.77 (95% CI 0.13-3.84; = 0.251). We found no statistically significant difference in the effectiveness and safety of ACT, when compared to APT in patients with similar cardiovascular risk factors and other baseline characteristics. Further prospective research is warranted.

摘要

为预防动脉粥样硬化血栓形成事件,外周动脉疾病患者通常会接受抗血小板治疗(APT)。然而,其中一些患者由于合并症而接受抗凝治疗(ACT)。我们的目的是确定在股腘动脉血管腔内血管重建术后患者中,这两种治疗方法在有效性和安全性方面可能存在的差异。我们回顾性分析了在一家单一的三级医疗中心成功进行股腘动脉血管重建术的1247例患者,并根据他们所接受的规定治疗将其分为ACT组或APT组。通过描述性统计对两组进行特征分析,并通过倾向得分匹配对其特征进行混杂因素调整。在血管重建术后一年内评估有效性和安全性结果。ACT组与APT组相比,全因死亡、外周动脉疾病加重以及因血管原因导致的大截肢这一复合结局的比值比为1.21(95%置信区间0.53 - 2.21;P = 0.484)。ACT组与APT组相比,按照国际血栓与止血学会定义的大出血的比值比为0.77(95%置信区间0.13 - 3.84;P = 0.251)。我们发现,在具有相似心血管危险因素和其他基线特征的患者中,与APT相比,ACT在有效性和安全性方面没有统计学上的显著差异。有必要进行进一步的前瞻性研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cf4b/9319551/eb3078280b3a/jcdd-09-00207-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cf4b/9319551/0aee40a6b66b/jcdd-09-00207-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cf4b/9319551/eb3078280b3a/jcdd-09-00207-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cf4b/9319551/0aee40a6b66b/jcdd-09-00207-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cf4b/9319551/eb3078280b3a/jcdd-09-00207-g002.jpg

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