Potsis Thomas Z, Katsouras Christos, Goudevenos John A
Department of Cardiology, Medical School, University of Ioannina, Greece.
Angiology. 2009 Apr-May;60(2):148-58. doi: 10.1177/0003319708317339. Epub 2008 May 28.
Antithrombotic therapy coupled with early use of cardiac catheterization and revascularization have decreased morbidity and mortality rates in patients who have acute ischemic heart disease but who carry a risk for bleeding. Bleeding complications in patients with acute coronary syndromes are associated with worse clinical outcomes, including recurrent ischemic events and death. Determining the appropriate balance between preventing ischemic events and causing bleeding in patients with acute coronary syndromes present a challenging problem for clinicians. Antithrombotics studied in recent clinical trials that have focused on bleeding reduction include bivalirudin and fondaparinux. In this review, the incidence, predictors, and clinical outcomes associated with bleeding are discussed. Furthermore, the association between antithrombotic agents and bleeding and propose strategies to prevent bleeding complications are also discussed.
抗栓治疗联合早期使用心导管插入术和血运重建术降低了患有急性缺血性心脏病但有出血风险患者的发病率和死亡率。急性冠状动脉综合征患者的出血并发症与更差的临床结局相关，包括复发性缺血事件和死亡。在急性冠状动脉综合征患者中确定预防缺血事件和引起出血之间的适当平衡对临床医生来说是一个具有挑战性的问题。近期专注于减少出血的临床试验中研究的抗栓药物包括比伐卢定和磺达肝癸钠。在本综述中，讨论了与出血相关的发生率、预测因素和临床结局。此外，还讨论了抗栓药物与出血之间的关联并提出预防出血并发症的策略。
