Lemesle G, Delhaye C
Service de cardiologie B, centre hémodynamique, clinique de cardiologie, hôpital cardiologique, CHRU de Lille, France. gilles
Ann Cardiol Angeiol (Paris). 2011 Dec;60(6):338-46. doi: 10.1016/j.ancard.2011.09.001. Epub 2011 Oct 11.
Stent thrombosis (ST) remains a major pitfall of stent implantation in contemporary percutaneous coronary intervention (PCI) leading to high rates of death and non-fatal myocardial infarction. Many predictors of ST have been reported worldwide but the strongest have to be highlighted regarding the catastrophic prognosis of such an event. Because platelet aggregation has a pivotal role in ST pathogenesis, the new antiplatelet regimens combining aspirin and P2Y12 receptor inhibitors have led to a remarkable decrease in the ST incidence, especially in the setting of acute coronary syndrome (ACS). In this article, our purpose is to review the evolution of ST incidence since first stent use in PCI. We will also overview the main predictors of ST focusing on ACS and clopidogrel low response.
支架内血栓形成(ST)仍然是当代经皮冠状动脉介入治疗(PCI)中支架植入的一个主要陷阱,会导致高死亡率和非致命性心肌梗死。全球已报道了许多ST的预测因素,但鉴于此类事件的灾难性预后,必须突出强调其中最有力的因素。由于血小板聚集在ST发病机制中起关键作用,联合使用阿司匹林和P2Y12受体抑制剂的新型抗血小板方案已使ST发生率显著降低,尤其是在急性冠状动脉综合征(ACS)的情况下。在本文中,我们的目的是回顾自首次在PCI中使用支架以来ST发生率的演变。我们还将概述ST的主要预测因素,重点关注ACS和氯吡格雷低反应。