【正文】 ontained herein is for Europe, Middle East and Africa, and Asia Pacific only, and not intended for physicians from France, Japan or the United States. 169。2020 Abbott. All rights reserved. AP2936456OUS Rev. B. 6 DAPT不依從的臨床分析 ? 臨床常見原因 – 出血：胃腸道出血，腦血管病等 – 計(jì)劃外手術(shù)：拔牙，腫瘤，外傷，結(jié)石（膽囊、腎臟 etc），前列腺肥大等 – 其他疾?。和达L(fēng) – DAPT過敏 – 腎功能不全、肝功能不全 – 經(jīng)濟(jì)因素 ? 帶來的后果 – 支架血栓、心梗、死亡 Information contained herein is for Europe, Middle East and Africa, and Asia Pacific only, and not intended for physicians from France, Japan or the United States. 169。103:11281135. Information contained herein is for Europe, Middle East and Africa, and Asia Pacific only, and not intended for physicians from France, Japan or the United States. 169。2020 Abbott. All rights reserved. AP2936456OUS Rev. B. 3 臨床工作常常面臨選擇 高出血風(fēng)險(xiǎn) 潛在停用 DAPT可能 再狹窄率高 高再狹窄風(fēng)險(xiǎn) 復(fù)雜病變 支架內(nèi)血栓風(fēng)險(xiǎn)增加 Photographs taken by and on file at Abbott Vascular. BMS? DES? Information contained herein is for Europe, Middle East and Africa, and Asia Pacific only, and not intended for physicians from France, Japan or the United States. 169。藥物支架植入后理想的抗血小板時(shí)間 — 更長或更短？ 羅建方 廣東省人民醫(yī)院 Information contained herein is for Europe, Middle East and Africa, and Asia Pacific only, and not intended for physicians from France, Japan or the United States. 169。2020 Abbott. All rights reserved. AP2936456OUS Rev. B. 2 內(nèi)容 ? 臨床使用 (Dural Antiplatelet Therapy, DAPT)難題 ? XIENCE DAPT中斷 /停用數(shù)據(jù) ? 不同 DES的安全性表現(xiàn) Information contained herein is for Europe, Middle East and Africa, and Asia Pacific only, and not intended for physicians from France, Japan or the United States. 169。2020 Abbott. All rights reserved. AP2936456OUS Rev. B. 4 隨著抗拴力度增強(qiáng)，缺血事件 ↓ 出血并發(fā)癥 ↑ Thromb Haemost. 2020。2020 Abbott. All rights reserved. AP2936456OUS Rev. B. 5 不同臨床研究中 DAPT依從情況 Resolute AC 雙 聯(lián) 抗血小板治 療 1年 3年 XIENCE V % % Endeavor Resolute % % SPIRITCOMPARE 雙 聯(lián) 抗血小板治 療 1年 2年 XIENCE V % % Taxus % % COMPARE 雙 聯(lián) 抗血小板治 療 1年 2年 XIENCE V 70% % Promus Element 70% % PLATINUM 雙 聯(lián) 抗血小板治 療 1年 2年 XIENCE V % 48% Promus Element % % Information contained herein is for Europe, Middle East and Africa, and Asia Pacific only, and not intended for physicians from France, Japan or the United States. 169。2020 Abbott. All rights reserved. AP2936456OUS Rev. B. 7 內(nèi)容 ? 臨 床使用 DAPT的 難題 ? XIENCE DAPT中斷 /停用數(shù)據(jù) ? 不同 DES的安全性表 現(xiàn) Information contained herein is for Europe, Middle East and Africa, and Asia Pacific only, and not intended for physicians from France, Japan or the United States. 169。2020 Abbott. All rights reserved. AP2936456OUS Rev. B. 9 XIENCE 獲得 CE批準(zhǔn) 3個(gè)月 DAPT Information contained herein is for Europe, Middle East and Africa, and Asia Pacific only, and not intended for physicians from France, Japan or the United States. 169。2020 Abbott. All rights reserved. AP2936456OUS Rev. B. 11 XIENCE V USA ? XIENCE V USA – 無對照注冊研究，共入選真實(shí)世界患者 5054名 – 主要終點(diǎn)為 1年期 ARC定 義 的確診的 /可能的支架血栓發(fā)生率 – 標(biāo)準(zhǔn)風(fēng)險(xiǎn)隊(duì)列是 XIENCE V USA 的一個(gè)亞組，患者特征與 SPIRIT III amp。2020 Abbott. All rights reserved. AP2936456OUS Rev. B. 12 Source: Dr. James Hermiller, XIENCE V USA Registry, 1Year Results, PCR 2020. AP2932510 Rev. A. Information contained herein for distribution outside the USA only. 169。2020 Abbott. All rights reserved. AP2936456OUS Rev. B. 13 Source: Dr. James Hermiller, XIENCE V USA Registry, 1Year Results, PCR 2020. 在 XIENCE V USA 中，間斷或停止 DAPT 后 ARC定義確診的 /可能的支架血栓發(fā)生率 (30 天 – 1 年 ) XIENCE V USA 在標(biāo)準(zhǔn)風(fēng)險(xiǎn)患者群中， 30天后間斷或停止 DAPT，支架血栓發(fā)生率為 0% 回 顧 2020 PCR Information contained herein is for Europe, Middle East and Africa, and Asia Pacific only, and not intended for physicians from France, Japan or the United States. 169。 Source: G Stone. Stent Thrombosis and DAPT Interruption: Insights from the XIENCE V Everolimus Eluting Coronary Stent System Trials. TCT 2020. XIENCE大型薈萃分析 2年 支架血栓大型薈萃分析 DAPT中斷與支架血栓的發(fā)生