Bhatt Deepak L
Veterans Affairs Boston Healthcare System, and Brigham and Women's Hospital, Boston, Massachusetts, USA.
Am J Cardiol. 2009 Feb 2;103(3 Suppl):11A-19A. doi: 10.1016/j.amjcard.2008.11.018.
Antiplatelet therapy is an important treatment modality across the spectrum of coronary artery disease manifestations. The role of aspirin in primary prevention continues to be refined. Although monotherapy with either aspirin or clopidogrel has been validated in secondary prevention, for high-risk patients such as those with acute coronary syndromes or requiring percutaneous coronary intervention, dual antiplatelet therapy appears to be most beneficial. Questions remain about the appropriate duration of dual antiplatelet therapy, especially in patients with prior ischemic events or in those receiving first-generation drug-eluting stents, with indirect evidence suggesting longer durations are better.
抗血小板治疗是冠心病全谱表现中一种重要的治疗方式。阿司匹林在一级预防中的作用仍在不断完善。虽然阿司匹林或氯吡格雷单药治疗在二级预防中已得到验证，但对于急性冠脉综合征患者或需要接受经皮冠状动脉介入治疗的高危患者等，双联抗血小板治疗似乎最为有益。双联抗血小板治疗的合适疗程仍存在疑问，尤其是在既往有缺血事件的患者或接受第一代药物洗脱支架的患者中，间接证据表明疗程更长效果更好。
