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目的:新近发生心肌梗死的患者的再发缺血事件风险增高。ESTEEM试验中,与安慰剂相比,心肌梗死后采用阿司匹林治疗的患者口服直接凝血酶抑制剂希美加群可降低新发缺血事件的风险。希美加群可持续降低凝血活性标记物[凝血酶原片段1+2(F1+2)及D-二聚体]的水平。本项亚研究旨在评估此类标记物的水平及活化部分凝血活酶时间(A PTT)与新发缺血事件或出血的关系。方法和结果:1883例患者中的518例被纳入亚研究中,这些患者在心肌梗死后14d内随机分配应用希美加群或安慰剂治疗6个月。
PURPOSE: Patients with a recent myocardial infarction have an increased risk of recurrent ischemic events. In the ESTEEM trial, oral administration of the direct-acting thrombin inhibitor, ximelagatran, reduced the risk of new ischemic events in patients treated with aspirin after myocardial infarction compared with placebo. Semeol continued to reduce the levels of coagulation-active markers [prothrombin fragments 1 + 2 (F1 + 2) and D-dimer]. This sub-study was designed to assess the level of such markers and the relationship between activated partial thromboplastin time (A PTT) and new-onset ischemic events or bleeding. Methods and Results: Of the 1883 patients, 518 were enrolled in the sub-study. These patients were randomly assigned to receive either simvastatin or placebo for 14 months after myocardial infarction.