The Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Curr Atheroscler Rep. 2013 Apr;15(4):318. doi: 10.1007/s11883-013-0318-8.
Contemporary management of acute coronary syndromes (ACS) has evolved to include rapid revascularization, potent antithrombotic, and antiplatelets, all of which reduce the risk of ischemic complications. Despite these advances, recurrent ischemic and bleeding event rates are still substantial. This increased risk post-percutaneous coronary intervention (PCI) has been the seminal event leading to recent clinical trials evaluating more potent antiplatelet drugs (prasugrel, ticagrelor, and protease-activated receptor-1 [PAR-1] inhibitors) and novel oral anticoagulants (NOAC). Ideally, an effective anticoagulation regimen adequately reduces the incidence of recurrent ischemia and limits iatrogenic bleeding. In this review, we will discuss the advances in ACS pharmacotherapy, review the recent trials evaluating these drugs, and discuss the major dilemmas in interpreting and implementing their findings.
急性冠状动脉综合征（ACS）的当代治疗方法已经发展到包括快速血运重建、强效抗血栓和抗血小板治疗，所有这些都降低了缺血并发症的风险。尽管有了这些进展，但缺血和出血事件的复发率仍然很高。经皮冠状动脉介入治疗（PCI）后这种风险增加，是导致最近评估更有效的抗血小板药物（普拉格雷、替格瑞洛和蛋白酶激活受体-1 [PAR-1]抑制剂）和新型口服抗凝剂（NOAC）的临床试验的重要原因。理想情况下，有效的抗凝方案能充分降低缺血复发的发生率并限制医源性出血。在这篇综述中，我们将讨论 ACS 药物治疗的进展，回顾评估这些药物的最新试验，并讨论解释和实施这些发现时的主要难题。
