冠状动脉旁路移植术后双联抗血小板治疗改善中远期临床预后:DACAB-FE研究解读  

Mid to long-term clinical outcomes improvement through dual antiplatelet therapy after coronary artery bypass grafting:Interpretation of DACAB-FE trial

作　　者：瞿建宇 陈思[2] 王志坚[3] 周康[4] 赵元[4] 董然[5] 史冬梅[3] 董念国[2] 郑哲 QU Jianyu;CHEN Si;WANG Zhijian;ZHOU Kang;ZHAO Yuan;DONG Ran;SHI Dongmei;DONG Nianguo;ZHENG Zhe(Department of Cardiovascular Surgey,Fuwai Hospital,National Center for Cardiovascular Diseases,National Clinical Research Center of Cardiovascular Diseases,State Key Laboratory of Cardiovascular Disease,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing,100037,P.R.China;Department of Cardiovascular Surgery,Union Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan,430022,P.R.China;Geriatric Cardiovascular Center,Beijing Anzhen Hospital,Capital Medical University,Beijing,100029,P.R.China;Department of Cardiovascular Surgery,The Second Xiangya Hospital of Central South University,Changsha,410011,P.R.China;Department of Cardiovascular Surgery,Beijing Anzhen Hospital,Capital Medical University,Beijing,100029,P.R.China)

机构地区：[1]中国医学科学院、北京协和医学院、国家心血管病中心、国家心血管疾病临床医学研究中心、心血管疾病国家重点实验室、阜外医院心血管外科,北京100037 [2]华中科技大学同济医学院附属协和医院心脏大血管外科,武汉430022 [3]首都医科大学附属北京安贞医院老年心血管病中心,北京100029 [4]中南大学湘雅二医院心血管外科,长沙410011 [5]首都医科大学附属北京安贞医院心脏外科,北京100029

出　　处：《中国胸心血管外科临床杂志》2024年第8期1096-1100,共5页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

基　　金：国家心血管疾病临床医学研究中心自主课题(NCRC2020004);湖南省科技厅临床医疗技术创新引导项目(2021SK53505)。

摘　　要：冠状动脉旁路移植术(CABG)是冠心病最有效的血运重建治疗手段之一,CABG后以抗血小板、降脂等药物为基础的二级预防策略是保证血运重建治疗效果持久性、预防中远期再发不良心脑血管事件的关键。上海交通大学附属瑞金医院赵强教授团队的前期研究(DACAB研究)结果表明,CABG术后双联抗血小板治疗(DAPT,即替格瑞洛+阿司匹林)可提高静脉血管通畅率,但DAPT能否进一步改善CABG患者中远期临床预后仍不清楚。近期,该团队报道了DACAB研究中远期随访结果(DACAB-FE研究),发现CABG术后DAPT可降低5年主要心血管事件发生率,改善患者中远期临床预后。本文将就DACAB-FE研究的方法学亮点及其重要临床意义进行解读。Coronary artery bypass grafting(CABG)is one of the most effective revascularization treatments for coronary heart disease.Secondary prevention strategies,which rely on antiplatelet and lipid-lowering drugs,are crucial after CABG to ensure the durability of revascularization treatment effects and prevent adverse cardiovascular and cerebrovascular events in the medium to long term.Previous research conducted by Professor Zhao Qiang's team from Ruijin Hospital of Shanghai Jiao Tong University,known as the DACAB study,indicated that dual antiplatelet therapy(DAPT,specifically ticagrelor+aspirin)after CABG can enhance venous graft patency.However,it remains uncertain whether DAPT can further improve the medium to long-term clinical outcomes of CABG patients.Recently,the team reported the medium to long-term follow-up results of the DACAB study,termed the DACAB-FE study,finding that DAPT administered after CABG can reduce the incidence of major cardiovascular events over five years and improve patients'medium to long-term clinical outcomes.This article will interpret the methodological highlights and significant clinical implications of the DACAB-FE study.

关 键 词：双联抗血小板治疗 冠状动脉旁路移植术 中远期结果 

分 类 号：R654.2[医药卫生—外科学]