{"title":"氯吡格雷对肥厚型心肌病猫有多大保护作用?","authors":"Mark Rishniw","doi":"10.2460/javma.24.04.0269","DOIUrl":null,"url":null,"abstract":"<p><p>Cats with hypertrophic cardiomyopathy (HCM) have a risk of developing aortic thromboembolism (ATE). Clopidogrel reduces the risk of redeveloping ATE and delays recurrence of ATE in cats that have experienced an ATE episode. Consequently, cardiologists have recommended administering clopidogrel to cats as a primary preventative, suggesting that all cats with severe HCM be administered clopidogrel. However, clopidogrel is unpalatable in its manufactured format, making such administration problematic for many clients. Therefore, estimating the potential benefit of administration might help clinicians determine on a case-by-case basis the need to treat cats with clopidogrel. Relatively simple statistical analyses of currently available data, along with certain assumptions and extrapolations, allow such an estimation of benefit in terms of relative and absolute risk reduction conferred by clopidogrel. Using this approach, and provided certain assumptions are true, clopidogrel likely confers a reduction in risk of ATE in cats with moderate to severe HCM of approximately 3% to 4%. Given the difficulty of administering clopidogrel to cats, clinicians should weigh these relatively small potential benefits against the potential harms (difficulty of administration) and not necessarily insist that clients administer clopidogrel.</p>","PeriodicalId":14658,"journal":{"name":"Javma-journal of The American Veterinary Medical Association","volume":null,"pages":null},"PeriodicalIF":1.6000,"publicationDate":"2024-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"How much protection does clopidogrel provide to cats with hypertrophic cardiomyopathy?\",\"authors\":\"Mark Rishniw\",\"doi\":\"10.2460/javma.24.04.0269\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Cats with hypertrophic cardiomyopathy (HCM) have a risk of developing aortic thromboembolism (ATE). Clopidogrel reduces the risk of redeveloping ATE and delays recurrence of ATE in cats that have experienced an ATE episode. Consequently, cardiologists have recommended administering clopidogrel to cats as a primary preventative, suggesting that all cats with severe HCM be administered clopidogrel. However, clopidogrel is unpalatable in its manufactured format, making such administration problematic for many clients. Therefore, estimating the potential benefit of administration might help clinicians determine on a case-by-case basis the need to treat cats with clopidogrel. Relatively simple statistical analyses of currently available data, along with certain assumptions and extrapolations, allow such an estimation of benefit in terms of relative and absolute risk reduction conferred by clopidogrel. Using this approach, and provided certain assumptions are true, clopidogrel likely confers a reduction in risk of ATE in cats with moderate to severe HCM of approximately 3% to 4%. Given the difficulty of administering clopidogrel to cats, clinicians should weigh these relatively small potential benefits against the potential harms (difficulty of administration) and not necessarily insist that clients administer clopidogrel.</p>\",\"PeriodicalId\":14658,\"journal\":{\"name\":\"Javma-journal of The American Veterinary Medical Association\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.6000,\"publicationDate\":\"2024-06-19\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Javma-journal of The American Veterinary Medical Association\",\"FirstCategoryId\":\"97\",\"ListUrlMain\":\"https://doi.org/10.2460/javma.24.04.0269\",\"RegionNum\":2,\"RegionCategory\":\"农林科学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/10/1 0:00:00\",\"PubModel\":\"Print\",\"JCR\":\"Q2\",\"JCRName\":\"VETERINARY SCIENCES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Javma-journal of The American Veterinary Medical Association","FirstCategoryId":"97","ListUrlMain":"https://doi.org/10.2460/javma.24.04.0269","RegionNum":2,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/10/1 0:00:00","PubModel":"Print","JCR":"Q2","JCRName":"VETERINARY SCIENCES","Score":null,"Total":0}
引用次数: 0
摘要
患有肥厚型心肌病 (HCM) 的猫有患主动脉血栓栓塞症 (ATE) 的风险。氯吡格雷可降低再次发生 ATE 的风险,并延缓发生过 ATE 的猫咪再次发生 ATE。因此,心脏病专家建议将氯吡格雷作为一级预防药物给猫使用,并建议所有患有严重 HCM 的猫都使用氯吡格雷。然而,氯吡格雷的制剂难以下咽,这使得许多客户难以接受。因此,估计给药的潜在益处可能有助于临床医生根据具体情况决定是否需要用氯吡格雷治疗猫咪。通过对现有数据进行相对简单的统计分析,再加上某些假设和推断,就可以估算出氯吡格雷在相对和绝对降低风险方面的益处。采用这种方法,并在某些假设成立的情况下,氯吡格雷可将中度至重度 HCM 猫的 ATE 风险降低约 3% 至 4%。考虑到给猫咪使用氯吡格雷的难度,临床医生应权衡这些相对较小的潜在益处和潜在危害(使用难度),而不一定坚持让客户使用氯吡格雷。
How much protection does clopidogrel provide to cats with hypertrophic cardiomyopathy?
Cats with hypertrophic cardiomyopathy (HCM) have a risk of developing aortic thromboembolism (ATE). Clopidogrel reduces the risk of redeveloping ATE and delays recurrence of ATE in cats that have experienced an ATE episode. Consequently, cardiologists have recommended administering clopidogrel to cats as a primary preventative, suggesting that all cats with severe HCM be administered clopidogrel. However, clopidogrel is unpalatable in its manufactured format, making such administration problematic for many clients. Therefore, estimating the potential benefit of administration might help clinicians determine on a case-by-case basis the need to treat cats with clopidogrel. Relatively simple statistical analyses of currently available data, along with certain assumptions and extrapolations, allow such an estimation of benefit in terms of relative and absolute risk reduction conferred by clopidogrel. Using this approach, and provided certain assumptions are true, clopidogrel likely confers a reduction in risk of ATE in cats with moderate to severe HCM of approximately 3% to 4%. Given the difficulty of administering clopidogrel to cats, clinicians should weigh these relatively small potential benefits against the potential harms (difficulty of administration) and not necessarily insist that clients administer clopidogrel.
期刊介绍:
Published twice monthly, this peer-reviewed, general scientific journal provides reports of clinical research, feature articles and regular columns of interest to veterinarians in private and public practice. The News and Classified Ad sections are posted online 10 days to two weeks before they are delivered in print.