PDF(Pubmed)
Abstract：
UNASSIGNED: In patients undergoing percutaneous coronary intervention (PCI), the use of anti-inflammatory therapy with colchicine is associated with a reduction of recurrent ischemic events. The mechanisms of such findings are not fully elucidated.
UNASSIGNED: To investigate the effects of colchicine versus aspirin on inflammation and platelet reactivity in patients with acute coronary syndrome (ACS) undergoing PCI.
UNASSIGNED: This observational study compared laboratory measurements in ACS patients receiving single antiplatelet therapy with ticagrelor or prasugrel plus colchicine (MACT) (n = 185) versus conventional dual-antiplatelet therapy (DAPT) with aspirin plus ticagrelor or prasugrel (n = 497). The primary outcome was the frequency of high residual inflammation, defined as high-sensitivity C-reactive protein (hs-CRP) ≥2 mg/L at 1 month post-PCI. Multiple sensitivity analyses were performed for the primary outcome, including multivariable adjustment, propensity-score matching, and inverse-probability weighted methods.
UNASSIGNED: One month after PCI, patients treated with MACT had significantly lower levels of hs-CRP compared to those treated with DAPT (0.6 [0.4-1.2] vs. 0.9 [0.6-2.3] mg/L, p < 0.001). The frequency of high residual inflammation was also lower in the MACT group (10.8% vs. 27.2%, p < 0.001) (odds ratio [95% confidence interval] = 0.33 [0.20-0.54], p < 0.001). This effect was consistent across sensitivity analyses. There was no difference in platelet reactivity between MACT and DAPT (49.6 ± 49.0 vs. 51.5 ± 66.4 P2Y12 reaction unit [PRU] measured by VerifyNow, p = 0.776).
UNASSIGNED: In ACS patients undergoing PCI, MACT was associated with a lower rate of high residual inflammation without increasing platelet reactivity compared to conventional DAPT.
UNASSIGNED: NCT04949516 for MACT pilot trial and NCT04650529 for Gyeongsang National University Hospital registry.
UNASSIGNED: To investigate the effects of colchicine versus aspirin on inflammation and platelet reactivity in patients with acute coronary syndrome (ACS) undergoing PCI.
UNASSIGNED: This observational study compared laboratory measurements in ACS patients receiving single antiplatelet therapy with ticagrelor or prasugrel plus colchicine (MACT) (n = 185) versus conventional dual-antiplatelet therapy (DAPT) with aspirin plus ticagrelor or prasugrel (n = 497). The primary outcome was the frequency of high residual inflammation, defined as high-sensitivity C-reactive protein (hs-CRP) ≥2 mg/L at 1 month post-PCI. Multiple sensitivity analyses were performed for the primary outcome, including multivariable adjustment, propensity-score matching, and inverse-probability weighted methods.
UNASSIGNED: One month after PCI, patients treated with MACT had significantly lower levels of hs-CRP compared to those treated with DAPT (0.6 [0.4-1.2] vs. 0.9 [0.6-2.3] mg/L, p < 0.001). The frequency of high residual inflammation was also lower in the MACT group (10.8% vs. 27.2%, p < 0.001) (odds ratio [95% confidence interval] = 0.33 [0.20-0.54], p < 0.001). This effect was consistent across sensitivity analyses. There was no difference in platelet reactivity between MACT and DAPT (49.6 ± 49.0 vs. 51.5 ± 66.4 P2Y12 reaction unit [PRU] measured by VerifyNow, p = 0.776).
UNASSIGNED: In ACS patients undergoing PCI, MACT was associated with a lower rate of high residual inflammation without increasing platelet reactivity compared to conventional DAPT.
UNASSIGNED: NCT04949516 for MACT pilot trial and NCT04650529 for Gyeongsang National University Hospital registry.
摘要：
■在接受经皮冠状动脉介入治疗（PCI）的患者中，使用秋水仙碱抗炎治疗可减少复发性缺血事件.这些发现的机制尚未完全阐明。
探讨秋水仙碱与阿司匹林对急性冠脉综合征（ACS）患者PCI术后炎症和血小板反应性的影响。
这项观察性研究比较了接受替格瑞洛或普拉格雷加秋水仙碱(MACT)单一抗血小板治疗(n=185)与阿司匹林加替格瑞洛或普拉格雷(n=497)的常规双联抗血小板治疗(DAPT)的ACS患者的实验室测量结果。主要结果是高残留炎症的频率，定义为PCI术后1个月高敏C反应蛋白（hs-CRP）≥2mg/L。对主要结局进行了多重敏感性分析，包括多变量调整，倾向得分匹配，和逆概率加权方法。
■PCI后一个月，与接受DAPT治疗的患者相比，接受MACT治疗的患者的hs-CRP水平显着降低（0.6[0.4-1.2]vs.0.9[0.6-2.3]mg/L,p<0.001)。在MACT组中，高残留炎症的频率也较低（10.8％vs.27.2%,p<0.001)(比值比[95%置信区间]=0.33[0.20-0.54]，p<0.001)。这种影响在敏感性分析中是一致的。MACT和DAPT之间的血小板反应性没有差异（49.6±49.0vs.通过VerifyNow测量51.5±66.4P2Y12反应单元[PRU]，p=0.776)。
■在接受PCI的ACS患者中，与常规DAPT相比，MACT与较低的高残留炎症发生率相关，而不会增加血小板反应性。
■用于MACT试点试验的NCT049516和用于庆尚国立大学医院注册的NCT04650529。
探讨秋水仙碱与阿司匹林对急性冠脉综合征（ACS）患者PCI术后炎症和血小板反应性的影响。
这项观察性研究比较了接受替格瑞洛或普拉格雷加秋水仙碱(MACT)单一抗血小板治疗(n=185)与阿司匹林加替格瑞洛或普拉格雷(n=497)的常规双联抗血小板治疗(DAPT)的ACS患者的实验室测量结果。主要结果是高残留炎症的频率，定义为PCI术后1个月高敏C反应蛋白（hs-CRP）≥2mg/L。对主要结局进行了多重敏感性分析，包括多变量调整，倾向得分匹配，和逆概率加权方法。
■PCI后一个月，与接受DAPT治疗的患者相比，接受MACT治疗的患者的hs-CRP水平显着降低（0.6[0.4-1.2]vs.0.9[0.6-2.3]mg/L,p<0.001)。在MACT组中，高残留炎症的频率也较低（10.8％vs.27.2%,p<0.001)(比值比[95%置信区间]=0.33[0.20-0.54]，p<0.001)。这种影响在敏感性分析中是一致的。MACT和DAPT之间的血小板反应性没有差异（49.6±49.0vs.通过VerifyNow测量51.5±66.4P2Y12反应单元[PRU]，p=0.776)。
■在接受PCI的ACS患者中，与常规DAPT相比，MACT与较低的高残留炎症发生率相关，而不会增加血小板反应性。
■用于MACT试点试验的NCT049516和用于庆尚国立大学医院注册的NCT04650529。
