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急性冠状动脉综合征合并糖尿病患者的抗栓治疗

Antithrombotic therapy in patients with acute coronary syndrome and diabetes mellitus.

作者信息

Farhan S, Tentzeris I, Freynhofer M K, Vogel B, Huber K

机构信息

3rd Department of Medicine, Cardiology and Emergency Medicine, Wilhelminenhospital, Vienna, Montleartstr. 37, 1160, Vienna, Austria.

出版信息

Herz. 2012 May;37(3):264-72. doi: 10.1007/s00059-012-3610-4.

DOI:10.1007/s00059-012-3610-4
PMID:22456988
Abstract

Acute coronary syndrome (ACS) is associated with high mortality even in the acute phase as well as in the post-acute (chronic) phase. Diabetes mellitus type 2 (DM-2), on the other hand, further increases mortality after ACS. Several new antiplatelet and antithrombotic drugs available for clinical use have also been investigated in patients with DM-2, and the guidelines of the European Society of Cardiology (ESC) were recently adapted. However, in daily clinical practice choosing the most suitable regimen is a challenge in many cases. This review article aims to shed light on and simplify antiplatelet and antithrombotic therapy in ACS patients with DM-2 in order to ease the clinician's decision-making.

摘要

急性冠状动脉综合征(ACS)即使在急性期以及急性后期(慢性期)都与高死亡率相关。另一方面,2型糖尿病(DM-2)会进一步增加ACS后的死亡率。几种可用于临床的新型抗血小板和抗血栓药物也已在DM-2患者中进行了研究,欧洲心脏病学会(ESC)的指南最近也进行了调整。然而,在日常临床实践中,在许多情况下选择最合适的治疗方案是一项挑战。这篇综述文章旨在阐明并简化DM-2的ACS患者的抗血小板和抗血栓治疗,以方便临床医生做出决策。

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本文引用的文献

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Dosing clopidogrel based on CYP2C19 genotype and the effect on platelet reactivity in patients with stable cardiovascular disease.基于 CYP2C19 基因型的氯吡格雷剂量调整与稳定型心血管疾病患者血小板反应性的关系。
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Thrombin-receptor antagonist vorapaxar in acute coronary syndromes.
凝血酶受体拮抗剂沃拉帕沙在急性冠脉综合征中的应用。
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RUBY-1: a randomized, double-blind, placebo-controlled trial of the safety and tolerability of the novel oral factor Xa inhibitor darexaban (YM150) following acute coronary syndrome.RUBY-1 研究:新型口服 Xa 因子抑制剂达比加群(YM150)治疗急性冠脉综合征的安全性和耐受性的随机、双盲、安慰剂对照研究。
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Intravenous enoxaparin or unfractionated heparin in primary percutaneous coronary intervention for ST-elevation myocardial infarction: the international randomised open-label ATOLL trial.静脉注射依诺肝素或普通肝素用于 ST 段抬高型心肌梗死的直接经皮冠状动脉介入治疗:国际随机开放标签 ATOLL 试验。
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Prasugrel vs. ticagrelor in acute coronary syndromes: which one to choose?普拉格雷与替格瑞洛在急性冠状动脉综合征中的应用:如何选择?
Wien Klin Wochenschr. 2011 Aug;123(15-16):468-76. doi: 10.1007/s00508-011-0027-7. Epub 2011 Aug 3.
8
Apixaban with antiplatelet therapy after acute coronary syndrome.急性冠脉综合征后应用阿哌沙班联合抗血小板治疗。
N Engl J Med. 2011 Aug 25;365(8):699-708. doi: 10.1056/NEJMoa1105819. Epub 2011 Jul 24.
9
Impact of diabetes mellitus on the safety and effectiveness of bivalirudin in patients with acute myocardial infarction undergoing primary angioplasty: analysis from the HORIZONS-AMI (Harmonizing Outcomes with RevasculariZatiON and Stents in Acute Myocardial Infarction) trial.糖尿病对行直接经皮冠状动脉介入治疗的急性心肌梗死患者使用比伐卢定的安全性和有效性的影响:来自 HORIZONS-AMI(急性心肌梗死血管重建和支架治疗与优化结果)试验的分析。
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Ticagrelor versus clopidogrel in patients with acute coronary syndromes intended for non-invasive management: substudy from prospective randomised PLATelet inhibition and patient Outcomes (PLATO) trial.替格瑞洛与氯吡格雷用于拟行非侵入性治疗的急性冠状动脉综合征患者:前瞻性随机 PLATelet inhibition and patient Outcomes (PLATO) 试验的亚组研究。
BMJ. 2011 Jun 17;342:d3527. doi: 10.1136/bmj.d3527.