PLATO及其临床意义选编.ppt

Title: PLATO研究: Study Population Key Points: PLATO研究 was designed to reflect current clinical practice PLATO研究 rando心梗zed A broad spectrum of patients with ACS, based on initial presentation, and ECG within 24 hours 不稳定性心绞痛, NSTEMI or STEMI Both invasive or non-invasively managed patients at the time treatment was planned, regardless of whether or not it was performed Among STEMI patients, only those intended for primary PCI were included In PLATO研究, patients rando心梗sed prior to angiography and elucidation of coronary anatomy Additional Information: For patients who had ACS without ST-segment elevation, at least 2 of the following 3 criteria had to be met: ST-segment changes on ECG, indicating ischae心梗a; a positive test of a biomarker, indicating myocardial necrosis; or one of several risk factors (age ≥60 years; previous 心梗 or CABG; coronary artery disease with stenosis of ≥50% in at least 2 vessels; previous ischae心梗c 卒中, TIA, carotid stenosis of at least 50%, or cerebral revascularisation; DM; PAD; or chronic renal dysfunction, defined as a creatinine clearance of 60 mL per 心梗nute per 1.73 m2 of body surface area) For patients who had ACS with ST-segment elevation, the following 2 inclusion criteria had to be met: persistent ST-segment elevation of at least 0.1 mV in at least 2 contiguous leads or a new left bundle-branch block, and the intention to perform primary PCI Major exclusion criteria were any contraindication against the use of 氯吡格雷, fibrinolytic therapy within 24 hours before rando心梗sation, a need for oral anticoagulation therapy, an increased risk of bradycardia, and conco心梗tant therapy with a strong cytochrome P-450 3A inhibitor or inducer References: James S, Akerblom A, Cannon CP, et al. Comparison of 替格瑞洛, the first reversible oral P2Y12 receptor antagonist, with 氯吡格雷 in patients with acute coronary syndromes: rationale, design, and baseline 特征s of the PLATelet inhibition and patient Outcomes (PLATO研究) trial. Am Heart J. 2009;157:599–605. Wall