Fabio Solis-Jiménez, Ximena Latapi-Ruiz Esparza, Hannah Priscila Guzman-Solorzano, Monserrat Villalobos-Pedroza, Luis Angel Morales-Villamil, Braiana Angeles Diaz-Herrera, Sarai Hernandez-Pastrana, Rodrigo Gopar-Nieto, Eduardo A Arias-Sanchez, Luis Alfonso Marroquín-Donday, Gian Manuel Jiménez-Rodríguez, Daniel Sierra-Lara, Diego Araiza-Garaygordobil, Alexandra Arias-Mendoza
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引用次数: 0
Abstract
Purpose: Patients with coronary ectasia (CAE) have an increased risk of major cardiovascular events (MACE). Current preventive treatments are uncertain, with oral anticoagulants often prescribed based on limited retrospective studies. Our aim is to help address the question: what is the most appropriate treatment?
Methods: Using a retrospective cohort of patients with an ACS and CAE in a single center in Mexico City, two groups were observed based on the treatment at discharge: dual antiplatelet therapy (group 1) and anticoagulation with either a VKA or a DOAC, regardless of antiplatelet therapy (group 2). The main outcome was MACE, which was a composite of all-cause mortality, reinfarction, and ischemic stroke at 4.5 years follow-up.
Results: A total of 354 patients admitted for ACS and CAE were included. 228 (64.4%) patients were classified in the DAPT group and 126 (35.5%) in the anticoagulants group. The DAPT group had higher type 2 diabetes rates, NSTEMI presentation, and lower-grade ectasia. The anticoagulation group had higher STEMI presentation and higher-grade ectasia. The DAPT group had 33 (14.5%) events of MACE, whereas the anticoagulation group had 16 (13.1%) events. Anticoagulants were not associated with a risk reduction of the primary endpoint (HR 0.95; 95% CI, 0.47-1.54; p = 0.59), nor any of the individual components.
Conclusion: This retrospective cohort study showed similar effectiveness between DAPT and anticoagulation in patients with ACS and CAE for preventing MACE, and lower bleeding risk. Further research is needed to identify optimal candidates for each antithrombotic regime.
期刊介绍:
Designed to objectively cover the process of bench to bedside development of cardiovascular drug, device and cell therapy, and to bring you the information you need most in a timely and useful format, Cardiovascular Drugs and Therapy takes a fresh and energetic look at advances in this dynamic field.
Homing in on the most exciting work being done on new therapeutic agents, Cardiovascular Drugs and Therapy focusses on developments in atherosclerosis, hyperlipidemia, diabetes, ischemic syndromes and arrhythmias. The Journal is an authoritative source of current and relevant information that is indispensable for basic and clinical investigators aiming for novel, breakthrough research as well as for cardiologists seeking to best serve their patients.
Providing you with a single, concise reference tool acknowledged to be among the finest in the world, Cardiovascular Drugs and Therapy is listed in Web of Science and PubMed/Medline among other abstracting and indexing services. The regular articles and frequent special topical issues equip you with an up-to-date source defined by the need for accurate information on an ever-evolving field. Cardiovascular Drugs and Therapy is a careful and accurate guide through the maze of new products and therapies which furnishes you with the details on cardiovascular pharmacology that you will refer to time and time again.