我们的网站为什么显示成这样?

可能因为您的浏览器不支持样式,您可以更新您的浏览器到最新版本,以获取对此功能的支持,访问下面的网站,获取关于浏览器的信息:

|本期目录/Table of Contents|

急性冠脉综合征应用磺达肝素钠与低分子肝素出血风险比较的meta分析

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2014年第2期
页码:
174-178
栏目:
临床研究
出版日期:
2014-01-20

文章信息/Info

Title:
Fondaparinux vs. low molecular weight heparin in bleeding risk of acute coronary syndrome: meta-analysis of prospective studies
作者:
王淑香曾 芳赵 强
(暨南大学第四附属医院、广州市红十字会医院心内科,广东 广州 510220)
Author(s):
WANG Shu-xiang ZENG Fang ZHAO Qiang
(Department of Cardiology, Guangzhou Red Cross Hospital & Fourth Affiliated Hospital of Jinan University, Guangzhou 510220, Guangdong, China)
关键词:
磺达肝素钠低分子肝素急性冠脉综合征出血安全性meta分析
Keywords:
Fondaparinux low molecular weight heparin acute coronary syndrome bleeding safety
分类号:
R541.4;R973.2
DOI:
-
文献标识码:
A
摘要:
目的:系统评价磺达肝素钠应用于急性冠脉综合征(acute coronary syndrome,ACS)的安全性。方法: 通过全面检索国内外关于低分子肝素(low molecular weight heparin,LMWH)和磺达肝素钠治疗ACS的随机对照研究文献,筛选出符合评价标准的文献,采用RevMan5.1软件进行meta分析,采用Stata 12.0 Egger线性回归法评估纳入文献的发表偏倚。结果: 磺达肝素钠组应用于ACS的主要出血事件(RR=0.53,95%CI:0.45-0.61;Z=8.10,P<0.01)、小出血事件(RR=0.33;95%CI:0.27-0.41;Z=10.30;P<0.01)以及总体出血事件(RR=0.44,95%CI:0.39-0.50;Z=13.03,P<0.01)的发生率均低于LMWH组,差别有统计学意义。结论: ACS应用磺达肝素钠较LMWH安全。。
Abstract:
AIM:To compare the safety between fondaparinux and low molecular weight heparin (LMWH) in patients with acute coronary syndrome (ACS), excluding ST-segment elevation myocardial infarction (STEMI). METHODS: The authors applied the techniques of meta-analysis to data extracted from the published literature addressing this relation. RESULTS: Five trials with a total of 20680 patients were included. Compared with LMWH, fondaparinux was associated with reduced major bleeding (risk ratio [RR]=0.53; 95% CI: 0.45 to 0.61; Z=8.10; P<0.01), minor bleeding (RR=0.33, 95% CI: 0.27 to 0.41; Z=10.30, P<0.01) and total bleeding (RR=0.44, 95% CI: 0.39 to 0.50; Z=13.03, P<0.01). CONCLUSION: Fondaparinux is safer than low molecular weight heparin in anticoagulant treatment of ACS.

参考文献/References

[1]Toschi V,Lettino M.Inhibitors of propagation of coagulation: factors V and X[J].Br J Clin Pharmacol,2011,2(4):563-580.
[2]Yan HB,Song L,Liu R,et al.Comparison of safety and efficacy between fondaparinux and nadroparin in non-ST elevation acute coronary syndromes[J].Chin Med J (Engl),2011,124(6):879-886.
[3]Cohen M,Blaber R,Demers C,et al.The ESSENCE Trial:Efficacy and Safety of Subcutaneous Enoxaparin in Unstable Angina and Non-Q-Wave MI.A double-blind,randomized,parallel-group,multicenter study comparing enoxaparin and intravenous unfractionated heparin: methods and design[J].J Thromb Thrombolysis,1997,4(2):271-274.
[4]Cohen M,Demers C,Gurfinkel EP,et al.A comparison of low- molecular-weight heparin with unfractionated heparin for unstable coronary artery disease.Efficacy and Safety of Subcutaneous Enoxaparin in Non-Q-Wave Coronary Events Study Group[J].N Engl J Med,1997,337(7):447-452.
[5]Wang QK,Guo M,Zhang YQ,et al.Comparison of therapeutic efficacy between fondaparinux and low molecular weight heparin for patients with acute coronary syndrome[J].Zhongguo Wei Zhong Bing Ji Jiu Yi Xue,2010,22(10):628-631.
[6]Budaj A,Eikelboom JW,Mehta SR,et al.Improving clinical outcomes by reducing bleeding in patients with non-ST-elevation acute coronary syndromes[J].Eur Heart J,2009,30(6):655-661.
[7]纪炳能,邝鸿生,陈扬波.磺达肝癸钠治疗不稳定型心绞痛临床疗效观察[J].基层医学论坛,2011, 15(32):998-999.
[8]袁长玲,张 雷,杜寿龙.磺达肝癸钠治疗高危不稳定型心绞痛44例观察[J].基层医学论坛,2012,16(7):886-887.
[9]Torres M,Moayedi S.Evaluation of the acutely dyspneic elderly patient[J].Clin. Geriatr Med,23(2):307-325.
[10]Steg PG,Huber K,Andreotti F,et al.Bleeding in acute coronary syndromes and percutaneous coronary interventions:position paper by the Working Group on Thrombosis of the European Society of Cardiology[J].Eur Heart J,2011,32(15):1854-1864.
[11]Mehran R,Pocock SJ,Stone GW,et al.Associations of major bleeding and myocardial infarction with the incidence and timing of mortality in patients presenting with non-ST-elevation acute coronary syndromes: a risk model from the ACUITY trial[J].Eur Heart J,2009,30(12):1457-1466.
[12]卫生部合理用药专家委员会.中国医师药师用药指南[M].重庆:重庆出版社,2009:842-843.
[13]Anderson JL,Adams CD,Antman EM,et al.ACC/AHA 2007 guidelines for the management of patients with unstable angina/non ST-elevation myocardial infarction: a report of the American College ofCardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 2002 Guidelines for the Management of Patients With Un-stable Angina/Non ST-Elevation Myocardial Infarction):developed in collaboration with the American College of Emergency Physicians, the Society for Cardiovascular Angiography and Interventions, and the Society of Thoracic Surgeons: endorsed by the American Association of Cardiovascular and Pulmonary Rehabilitation and the Society for Academic Emergency Medicine[J].Circulation,2007,116(7):e148-e304.
[14]Hamm CW,Bassand JP,Agewall S,et al.ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation:The Task Force for themanagement of acute coronary syndromes(ACS)in patients presenting without persistent ST-segment elevation of the European Society of Cardiology (ESC)[J].Eur Heart J,2011,32(23):2999-3054.
[15]Pepe C,Machado M,Olimpio A,et al.Cost-effectiveness of fondaparinux in patients with acute coronary syndrome without ST-segment elevation[J].Arq Bras Cardiol,2012,99(1):613-622.

备注/Memo

备注/Memo:
收稿日期:2013-09-10.
通讯作者:赵强,教授,主要从事冠心病研究Email:scheldon@163.com
作者简介:王淑香,医师,硕士生Email:scentwang@126.com
更新日期/Last Update: 2014-01-16