Duke Clinical Research Institute, Duke University Medical Center, Durham, NC 27710, USA.
J Thromb Thrombolysis. 2010 May;29(4):516-28. doi: 10.1007/s11239-009-0437-9.
The use of anticoagulant and antiplatelet therapy during the management of acute coronary syndromes (ACS) has been associated with improvements in short- and long-term clinical outcomes, regardless of whether patients are managed conservatively or with acute coronary revascularization. Translating the existing evidence for selection of the most appropriate antithrombotic strategy has been summarized in available guideline recommendations. Given the breadth of antithrombotic recommendations across existing U.S. and European guidelines, synthesis of these recommendations for practicing clinicians who treat patients with ACS are increasingly desired. Providing a summary of the similarities across guidelines while noting the areas where divergence exists becomes an important facet in translating optimal antithrombotic management in ACS for the treating clinician. This review highlights the important aspects of clinical practice guidelines that practicing physicians should consider when selecting antithrombotic therapies to reduce ischemic risk while minimizing hemorrhagic risk across all ACS subtypes.
在急性冠状动脉综合征（ACS）的管理中使用抗凝和抗血小板治疗，无论患者是否接受保守治疗还是急性冠状动脉血运重建治疗，均可改善短期和长期临床结局。现有的指南建议总结了选择最合适的抗血栓策略的现有证据。鉴于现有的美国和欧洲指南中抗血栓治疗建议的广泛性，越来越需要为治疗 ACS 患者的临床医生综合这些建议。在为治疗医生翻译 ACS 最佳抗血栓治疗时，提供指南之间的相似点摘要，同时注意存在分歧的领域，这成为一个重要方面。这篇综述强调了临床实践指南中重要的方面，当选择抗血栓治疗以降低所有 ACS 亚型的缺血风险并最大程度减少出血风险时，临床医生应考虑这些方面。
