Bhatty Shaun, Ali Asghar, Shetty Ranjith, Sumption Kevin F, Topaz On, Jovin Ion S
Department of Internal Medicine, Cardiovascular Division, Virginia Commonwealth University Health System/Medical College of Virginia, Richmond, VA, USA.
Expert Rev Cardiovasc Ther. 2014 Apr;12(4):451-61. doi: 10.1586/14779072.2014.885839. Epub 2014 Feb 10.
The proper use of anticoagulants is crucial for ensuring optimal patient outcomes post percutaneous interventions in the cardiac catheterization laboratory. Anticoagulant agents such as unfractionated heparin, a thrombin inhibitor; low-molecular weight heparins, predominantly Factor Xa inhibitors; fondaparinux, a Factor Xa inhibitor and bivalirudin, a direct thrombin inhibitor have been developed to target various steps in the coagulation cascade to prevent formation of thrombin. Optimal anticoagulation achieves the correct balance between thrombosis and bleeding and is related to optimal outcomes with minimal complications. This review will discuss the mechanisms and appropriate use of current and emerging anticoagulant therapies used during percutaneous interventions.
正确使用抗凝剂对于确保心脏导管实验室经皮介入治疗后患者获得最佳治疗效果至关重要。已研发出多种抗凝剂，如普通肝素（一种凝血酶抑制剂）、低分子量肝素（主要是Xa因子抑制剂）、磺达肝癸钠（一种Xa因子抑制剂）和比伐卢定（一种直接凝血酶抑制剂），以针对凝血级联反应的不同步骤来预防凝血酶形成。最佳抗凝状态可在血栓形成和出血之间实现正确平衡，并与并发症最少的最佳治疗效果相关。本综述将讨论经皮介入治疗期间使用的现有和新型抗凝疗法的作用机制及合理应用。
