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PERSEO 注册研究:口服抗凝药物和冠状动脉支架治疗患者的管理

Design of the PERSEO Registry on the management of patients treated with oral anticoagulants and coronary stent.

机构信息

Interventional Cardiology, Sandro Pertini Hospital, Rome.

Division of Cardiology, Department of Advanced Biomedical Sciences, University of Naples Federico II.

出版信息

J Cardiovasc Med (Hagerstown). 2022 Nov 1;23(11):738-743. doi: 10.2459/JCM.0000000000001372. Epub 2022 Sep 7.

Abstract

AIM

Percutaneous coronary intervention with stent implantation (PCI-S) in patients requiring chronic oral anticoagulant therapy (OAC) is associated with an increased risk of bleeding and ischemic complications. Different randomized studies showed a significant advantage of a double antithrombotic therapy and superiority of direct oral anticoagulant (DOAC) compared with warfarin, but real-world data are limited. Aim is to evaluate the antithrombotic management and clinical outcome of patients with an indication for OAC who undergo PCI-S in a 'real-world' setting.

METHODS

The multicentre prospective observational PERSEO (PERcutaneouS coronary intErventions in patients treated with Oral anticoagulant therapy) Registry (ClinicalTrials.gov Identifier: NCT03392948) has been designed to enrol patients requiring OAC treated by PCI-S in 25 Italian centres. A target of at least 1080 patients will be followed for 1 year and data on thromboembolic and bleeding events and changes in antithrombotic therapy will be registered. The primary end point is a combined measure of efficacy and safety outcome (NACE), including major bleeding events and major adverse cardiac and cerebral events at 1-year follow-up in patients treated with DOAC (and dual or triple antiplatelet therapy) compared with the corresponding strategies with vitamin K antagonists. A secondary prespecified analysis has been defined to evaluate NACE in dual versus triple antithrombotic therapy after hospital discharge at 1-year follow-up.

CONCLUSION

The PERSEO Registry will investigate in a 'real world' setting the safety and efficacy of DOAC versus warfarin and dual versus triple antithrombotic therapy in patients with indication for oral anticoagulant therapy who undergo PCI-S.

摘要

目的

需要长期口服抗凝治疗(OAC)的患者行经皮冠状动脉介入治疗(PCI-S)与出血和缺血性并发症风险增加相关。不同的随机研究表明,双联抗血栓治疗具有显著优势,且直接口服抗凝剂(DOAC)优于华法林,但真实世界数据有限。本研究旨在评估在真实世界环境下,行 PCI-S 的 OAC 适应证患者的抗栓管理和临床结局。

方法

多中心前瞻性观察性 PERSEO(接受口服抗凝治疗的经皮冠状动脉介入治疗患者)登记研究(ClinicalTrials.gov 标识符:NCT03392948)旨在纳入 25 家意大利中心行 PCI-S 的 OAC 治疗患者。将至少随访 1080 例患者 1 年,登记血栓栓塞和出血事件以及抗栓治疗变化的数据。主要终点是 DOAC(双联或三联抗血小板治疗)与维生素 K 拮抗剂治疗患者的 1 年随访时的有效性和安全性复合终点(NACE),包括大出血事件和主要心脏和脑不良事件。还定义了次要预设分析,以评估 1 年随访时出院后双联与三联抗栓治疗的 NACE。

结论

PERSEO 登记研究将在真实世界环境下评估 DOAC 与华法林以及双联与三联抗栓治疗在需要 OAC 治疗而行 PCI-S 的患者中的安全性和有效性。

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