Vik-Mo Harald
Hjertemedisinsk avdeling, St. Olavs hospital.
Tidsskr Nor Laegeforen. 2011 Feb 4;131(3):252-3. doi: 10.4045/tidsskr.09.1176.
Dual antiplatelet therapy (acetylsalicylic acid and a thienopyridine) is essential after coronary stent implantation, and in the treatment of acute coronary syndrome. Many patients also need oral anticoagulation. Unfortunately, there are no prospective randomised trials to guide therapy. Triple antithrombotic therapy with acetylsalicylic acid, clopidogrel and warfarin is most commonly used. This regimen can reduce the risk of thrombosis and thromboembolism, but is associated with an increased risk of bleeding. Measures that reduce the risk of complications are reduction of INR with careful monitoring, a short duration of triple therapy (when possible) and use of radial access and a bare metal stent.
双联抗血小板治疗（阿司匹林和噻吩并吡啶）在冠状动脉支架植入术后以及急性冠状动脉综合征的治疗中至关重要。许多患者还需要口服抗凝药。遗憾的是，尚无前瞻性随机试验来指导治疗。最常用的是阿司匹林、氯吡格雷和华法林的三联抗栓治疗。该方案可降低血栓形成和血栓栓塞的风险，但出血风险增加。降低并发症风险的措施包括通过仔细监测降低国际标准化比值（INR）、尽可能缩短三联治疗疗程以及采用桡动脉入路和使用裸金属支架。
