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JACC:吗啡会增加服用氯吡格雷的非ST段抬高型冠心病患者的缺血风险

2020-02-06 不详 MedSci原创

既往的基础研究已经证明吗啡可以减弱口服二磷酸腺苷受体阻滞剂的抗血小板作用,但是临床的结果却是相反。本研究的目的旨在评估吗啡与接受氯吡格雷治疗的非ST段抬高急性冠脉综合征(NSTEACS)缺血事件发生的相关性。本研究纳入分析了EARLY ACS临床试验中的5438名NSTEACS患者,终点事件是96h的死亡、心梗、反复缺血或血栓性抢救的复合事件,和30天死亡或心梗的复合事件。在接受氯吡格雷治疗的患者

既往的基础研究已经证明吗啡可以减弱口服二磷酸腺苷受体阻滞剂的抗血小板作用,但是临床的结果却是相反。本研究的目的旨在评估吗啡与接受氯吡格雷治疗的非ST段抬高急性冠脉综合征(NSTEACS)缺血事件发生的相关性。

本研究纳入分析了EARLY ACS临床试验中的5438名NSTEACS患者,终点事件是96h的死亡、心梗、反复缺血或血栓性抢救的复合事件,和30天死亡或心梗的复合事件。在接受氯吡格雷治疗的患者中,吗啡与更高的96h 复合终点事件发生率相关(p = 0.026)。在没有接受氯吡格雷治疗的患者中,吗啡与96h的复合终点事件和30天的复合终点事件发生均不相关。

研究结果显示,在接受氯吡格雷治疗的非ST段抬高急性冠脉综合征患者中,吗啡会增加患者的缺血事件发生风险。

原始出处:

本文系梅斯医学(MedSci)原创编译整理,转载需授权


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    2021-01-16 hbwxf
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encryptionId=de2d99226e2, topicName=非ST段)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=04ce158, createdName=lxg951, createdTime=Thu Jul 30 10:29:00 CST 2020, time=2020-07-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1326472, encodeId=f71f13264e26f, content=<a href='/topic/show?id=96c71804b7' target=_blank style='color:#2F92EE;'>#ACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1804, encryptionId=96c71804b7, topicName=ACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1e452500029, createdName=12498568m50暂无昵称, createdTime=Sat Feb 08 07:29:00 CST 2020, time=2020-02-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1346570, encodeId=8c7213465e044, content=<a href='/topic/show?id=2013391531d' target=_blank style='color:#2F92EE;'>#吗啡#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=86, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=39153, encryptionId=2013391531d, topicName=吗啡)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8f0715, createdName=showtest, createdTime=Sat Feb 08 07:29:00 CST 2020, time=2020-02-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1423099, encodeId=d2cd1423099ca, content=<a href='/topic/show?id=936c16863b5' target=_blank style='color:#2F92EE;'>#ST段抬高#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=16863, encryptionId=936c16863b5, topicName=ST段抬高)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=91d33758978, createdName=gdsun, createdTime=Sat Feb 08 07:29:00 CST 2020, time=2020-02-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1447767, encodeId=91b0144e76763, content=<a href='/topic/show?id=523a3082670' target=_blank style='color:#2F92EE;'>#冠心病患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30826, encryptionId=523a3082670, topicName=冠心病患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=99445365987, createdName=liubm557, createdTime=Sat Feb 08 07:29:00 CST 2020, time=2020-02-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1624426, encodeId=475316244266c, content=<a href='/topic/show?id=f27b16862d9' target=_blank style='color:#2F92EE;'>#ST段#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=16862, encryptionId=f27b16862d9, topicName=ST段)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=676820671866, createdName=hyf035, createdTime=Sat Feb 08 07:29:00 CST 2020, time=2020-02-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=378959, encodeId=abdc3e895960, content=非常好的文章,学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=115, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=43a21971117, createdName=njwbhuang, createdTime=Thu Feb 06 17:35:52 CST 2020, time=2020-02-06, status=1, ipAttribution=)]
    2020-07-30 lxg951
  5. [GetPortalCommentsPageByObjectIdResponse(id=1926999, encodeId=3b7e1926999d1, content=<a href='/topic/show?id=be549922826' target=_blank style='color:#2F92EE;'>#非ST段抬高#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99228, encryptionId=be549922826, topicName=非ST段抬高)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5ed3112, createdName=echonoir, createdTime=Sat Aug 15 01:29:00 CST 2020, time=2020-08-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1854643, encodeId=b10e185464366, content=<a href='/topic/show?id=48351020537' target=_blank style='color:#2F92EE;'>#JACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10205, encryptionId=48351020537, topicName=JACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=55ce62, 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encryptionId=de2d99226e2, topicName=非ST段)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=04ce158, createdName=lxg951, createdTime=Thu Jul 30 10:29:00 CST 2020, time=2020-07-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1326472, encodeId=f71f13264e26f, content=<a href='/topic/show?id=96c71804b7' target=_blank style='color:#2F92EE;'>#ACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1804, encryptionId=96c71804b7, topicName=ACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1e452500029, createdName=12498568m50暂无昵称, createdTime=Sat Feb 08 07:29:00 CST 2020, time=2020-02-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1346570, encodeId=8c7213465e044, content=<a href='/topic/show?id=2013391531d' target=_blank style='color:#2F92EE;'>#吗啡#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=86, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=39153, encryptionId=2013391531d, topicName=吗啡)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8f0715, createdName=showtest, createdTime=Sat Feb 08 07:29:00 CST 2020, time=2020-02-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1423099, encodeId=d2cd1423099ca, content=<a href='/topic/show?id=936c16863b5' target=_blank style='color:#2F92EE;'>#ST段抬高#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=16863, encryptionId=936c16863b5, topicName=ST段抬高)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=91d33758978, createdName=gdsun, createdTime=Sat Feb 08 07:29:00 CST 2020, time=2020-02-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1447767, encodeId=91b0144e76763, content=<a href='/topic/show?id=523a3082670' target=_blank style='color:#2F92EE;'>#冠心病患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30826, encryptionId=523a3082670, topicName=冠心病患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=99445365987, createdName=liubm557, createdTime=Sat Feb 08 07:29:00 CST 2020, time=2020-02-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1624426, encodeId=475316244266c, content=<a href='/topic/show?id=f27b16862d9' target=_blank style='color:#2F92EE;'>#ST段#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=16862, encryptionId=f27b16862d9, topicName=ST段)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=676820671866, createdName=hyf035, createdTime=Sat Feb 08 07:29:00 CST 2020, time=2020-02-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=378959, encodeId=abdc3e895960, content=非常好的文章,学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=115, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=43a21971117, createdName=njwbhuang, createdTime=Thu Feb 06 17:35:52 CST 2020, time=2020-02-06, status=1, ipAttribution=)]
  6. [GetPortalCommentsPageByObjectIdResponse(id=1926999, encodeId=3b7e1926999d1, content=<a href='/topic/show?id=be549922826' target=_blank style='color:#2F92EE;'>#非ST段抬高#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99228, encryptionId=be549922826, topicName=非ST段抬高)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5ed3112, createdName=echonoir, createdTime=Sat Aug 15 01:29:00 CST 2020, time=2020-08-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1854643, encodeId=b10e185464366, content=<a href='/topic/show?id=48351020537' target=_blank style='color:#2F92EE;'>#JACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10205, encryptionId=48351020537, topicName=JACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=55ce62, createdName=hbwxf, createdTime=Sat Jan 16 16:29:00 CST 2021, time=2021-01-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2066049, encodeId=eefd2066049a8, content=<a href='/topic/show?id=fec79922910' target=_blank style='color:#2F92EE;'>#非ST段抬高型#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99229, encryptionId=fec79922910, topicName=非ST段抬高型)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1e452500029, createdName=12498568m50暂无昵称, createdTime=Sun Apr 19 11:29:00 CST 2020, time=2020-04-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1819114, encodeId=55191819114ba, content=<a href='/topic/show?id=de2d99226e2' target=_blank style='color:#2F92EE;'>#非ST段#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99226, encryptionId=de2d99226e2, topicName=非ST段)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=04ce158, createdName=lxg951, createdTime=Thu Jul 30 10:29:00 CST 2020, time=2020-07-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1326472, encodeId=f71f13264e26f, content=<a href='/topic/show?id=96c71804b7' target=_blank style='color:#2F92EE;'>#ACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1804, encryptionId=96c71804b7, topicName=ACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1e452500029, createdName=12498568m50暂无昵称, createdTime=Sat Feb 08 07:29:00 CST 2020, time=2020-02-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1346570, encodeId=8c7213465e044, content=<a href='/topic/show?id=2013391531d' target=_blank style='color:#2F92EE;'>#吗啡#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=86, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=39153, encryptionId=2013391531d, topicName=吗啡)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8f0715, createdName=showtest, createdTime=Sat Feb 08 07:29:00 CST 2020, time=2020-02-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1423099, encodeId=d2cd1423099ca, content=<a href='/topic/show?id=936c16863b5' target=_blank style='color:#2F92EE;'>#ST段抬高#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=16863, encryptionId=936c16863b5, topicName=ST段抬高)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=91d33758978, createdName=gdsun, createdTime=Sat Feb 08 07:29:00 CST 2020, time=2020-02-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1447767, encodeId=91b0144e76763, content=<a href='/topic/show?id=523a3082670' target=_blank style='color:#2F92EE;'>#冠心病患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30826, encryptionId=523a3082670, topicName=冠心病患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=99445365987, createdName=liubm557, createdTime=Sat Feb 08 07:29:00 CST 2020, time=2020-02-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1624426, encodeId=475316244266c, content=<a href='/topic/show?id=f27b16862d9' target=_blank style='color:#2F92EE;'>#ST段#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=16862, encryptionId=f27b16862d9, topicName=ST段)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=676820671866, createdName=hyf035, createdTime=Sat Feb 08 07:29:00 CST 2020, time=2020-02-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=378959, encodeId=abdc3e895960, content=非常好的文章,学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=115, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=43a21971117, createdName=njwbhuang, createdTime=Thu Feb 06 17:35:52 CST 2020, time=2020-02-06, status=1, ipAttribution=)]
    2020-02-08 showtest
  7. 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href='/topic/show?id=523a3082670' target=_blank style='color:#2F92EE;'>#冠心病患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30826, encryptionId=523a3082670, topicName=冠心病患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=99445365987, createdName=liubm557, createdTime=Sat Feb 08 07:29:00 CST 2020, time=2020-02-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1624426, encodeId=475316244266c, content=<a href='/topic/show?id=f27b16862d9' target=_blank style='color:#2F92EE;'>#ST段#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=16862, encryptionId=f27b16862d9, topicName=ST段)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=676820671866, createdName=hyf035, createdTime=Sat Feb 08 07:29:00 CST 2020, time=2020-02-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=378959, encodeId=abdc3e895960, content=非常好的文章,学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=115, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=43a21971117, createdName=njwbhuang, createdTime=Thu Feb 06 17:35:52 CST 2020, time=2020-02-06, status=1, ipAttribution=)]
    2020-02-08 gdsun
  8. 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  9. 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time=2020-02-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=378959, encodeId=abdc3e895960, content=非常好的文章,学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=115, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=43a21971117, createdName=njwbhuang, createdTime=Thu Feb 06 17:35:52 CST 2020, time=2020-02-06, status=1, ipAttribution=)]
    2020-02-08 hyf035
  10. 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time=2020-02-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=378959, encodeId=abdc3e895960, content=非常好的文章,学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=115, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=43a21971117, createdName=njwbhuang, createdTime=Thu Feb 06 17:35:52 CST 2020, time=2020-02-06, status=1, ipAttribution=)]
    2020-02-06 njwbhuang

    非常好的文章,学习了!

    0

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