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房颤抗凝患者合并急性冠脉综合征和/或接受经皮冠状动脉介入治疗/支架置入术时的抗栓治疗

Antithrombotic therapy in anticoagulated patients with atrial fibrillation presenting with acute coronary syndromes and/or undergoing percutaneous coronary intervention/stenting.

作者信息

Wrigley Benjamin J, Tapp Luke D, Shantsila Eduard, Lip Gregory Yh

机构信息

Haemostasis Thrombosis and Vascular Biology Unit, University of Birmingham Centre for Cardiovascular Sciences, City Hospital, Birmingham, England, United Kingdom.

出版信息

Pol Arch Med Wewn. 2010 Jul;120(7-8):290-3.

Abstract

The management of antithrombotic therapy in atrial fibrillation patients presenting with acute coronary syndrome and/or undergoing percutaneous coronary inter vention/stenting cannot be done according to a regimented common protocol, and stroke and bleeding risk stratification schema should be employed to individualize treatment options. A delicate balance is needed between the prevention of thromboembolism, against recurrent cardiac ischemia or stent thrombosis, and bleeding risk. New guidance from a consensus document of the European Society of Cardiology Working Group on Thrombosis, endorsed by the European Heart Rhythm Association and the European Association of Percutaneous Cardiovascular Interventions on the management of Antithrombotic Therapy in Atrial Fibrillation Patients Presenting with Acute Coronary Syndrome and/or Undergoing Percutaneous Coronary Intervention/Stenting has sought to clarify some of the major issues and problems surrounding this practice, and will allow clinicians to make much more informed decisions when faced with treating such patients.

摘要

对于合并急性冠脉综合征和/或接受经皮冠状动脉介入治疗/支架置入术的房颤患者,抗栓治疗不能按照固定的通用方案进行,而应采用卒中与出血风险分层方案来个体化选择治疗方案。在预防血栓栓塞、预防复发性心脏缺血或支架内血栓形成以及出血风险之间需要达到微妙的平衡。欧洲心脏病学会血栓形成工作组的一份共识文件中的新指南,得到了欧洲心律协会和欧洲经皮心血管介入协会的认可,该指南旨在阐明房颤患者合并急性冠脉综合征和/或接受经皮冠状动脉介入治疗/支架置入术时抗栓治疗的一些主要问题,这将使临床医生在面对此类患者的治疗时能够做出更明智的决策。

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