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首页> 外文期刊>Archives of cardiovascular diseases. Supplements >Safety of prasugrel in real-world patients with ST-segment elevation myocardial infarction: 1-year results from a prospective observational study (Bleeding and Myocardial Infarction Study)
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Safety of prasugrel in real-world patients with ST-segment elevation myocardial infarction: 1-year results from a prospective observational study (Bleeding and Myocardial Infarction Study)

机译：普拉格雷在现实世界中ST段抬高型心肌梗死患者中的安全性：前瞻性观察研究（出血和心肌梗死研究）的1年结果

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Summary Background. — Antiplatelet therapies, including prasugrel, are a cornerstone in the treatment of ST-segment elevation myocardial infarction (STEAAI), but are associated with a bleeding risk. This risk has been evaluated in randomized trials, but few data on real-world patients are available. Aim. — To evaluate prasugrel safety in real-world patients with STEMI. Methods. - Consecutive patients with STEMI were recruited over 1 year. Follow-up was done at 3 months and 1 year to evaluate prasugrel safety from hospital discharge to the STEMI anniversary date. The primary outcome was occurrence of any major bleeding according to the Bleeding Academic Research Consortium (BARC) 3 or 5 definitions, or minor bleeding according to the BARC 2 definition. Results. - Overall, 1083 patients were recruited. Compared to patients treated with aspirin+ clopidogrel, patients treated with aspirin + prasugrel had fewer BARC 3 or 5 bleedings (two [0.4%] patients vs. nine [1.8%] patients; P=0.04), but more BARC 2 bleedings (45 [9.3%] patients vs. 20 [4.0%] patients; P<0.001). The baseline characteristics of prasugrel-and clopidogrel-treated patients differed because the former were carefully selected (younger, higher body mass index, less frequent history of stroke). In the overall population, rates of in-hospital and out-of-hospital major bleeding were 2.6% (n = 28) and 1.3% (n = 13), respectively. Conclusion. — The rate of major bleeding, particularly out-of-hospital bleeding, in patients treated with prasugrel is low within 1 year after a STEMI. Accurate selection of patient candidates for prasugrel is likely to have reduced the risk of bleeding.
机译：摘要背景。 —抗血小板疗法（包括普拉格雷）是ST段抬高型心肌梗死（STEAAI）治疗的基石，但与出血风险相关。已经在随机试验中评估了这种风险，但是几乎没有关于实际患者的数据。目标。 —评估真实世界中STEMI患者的普拉格雷安全性。方法。 -连续1年招募连续性STEMI患者。在3个月零1年时进行随访，以评估从出院到STEMI周年纪念日的普拉格雷安全性。主要结局是根据出血学术研究协会（BARC）3或5定义发生的任何大出血，或根据BARC 2定义的发生小出血。结果。 -总共招募了1083名患者。与接受阿司匹林+氯吡格雷治疗的患者相比，接受阿司匹林+普拉格雷治疗的患者的BARC 3或5出血少（2例[0.4％]，9例[1.8％]患者; P = 0.04），但BARC 2出血更多（45 [ 9.3％]的患者与20 [4.0％]的患者; P <0.001）。普拉格雷和氯吡格雷治疗的患者的基线特征有所不同，因为前者是经过精心选择的（年轻，体重指数较高，中风史较少）。在总人口中，院内和院外大出血发生率分别为2.6％（n = 28）和1.3％（n = 13）。结论。 — STEMI后1年内，接受普拉格雷治疗的患者的大出血率，尤其是院外出血率低。准确选择普拉格雷的患者候选人可能会减少出血的风险。

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