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下一代药物洗脱支架时代的双联抗血小板治疗持续时间

Duration of dual antiplatelet treatment in the era of next generation drug-eluting stents.

作者信息

Rha Seung-Woon

机构信息

Seung-Woon Rha, Cardiovascular Center, Korea University Guro Hospital, Seoul 152-703, South Korea.

出版信息

World J Cardiol. 2014 Apr 26;6(4):148-53. doi: 10.4330/wjc.v6.i4.148.

DOI:10.4330/wjc.v6.i4.148
PMID:24772255
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3999335/
Abstract

Current percutaneous coronary intervention guidelines recommend dual antiplatelets (aspirin 100 mg + clopidogrel 75 mg daily) for at least 12 mo following drug-eluting stent (DES) implantation if patients are not at high risk of bleeding. Several reports have tried to shorten the dual antiplatelet therapy to 3-6 mo, especially following next-generation DES implantation, for cost-effectiveness. However, the clinical results are inconsistent and the data regarding next-generation DESs limited. In this report, recently published important pivotal reports regarding the optimal duration of dual antiplatelets following DES implantation are summarized.

摘要

目前的经皮冠状动脉介入治疗指南建议，如果患者没有高出血风险，在药物洗脱支架（DES）植入后至少12个月给予双联抗血小板治疗（阿司匹林100毫克+氯吡格雷75毫克每日）。一些报告试图将双联抗血小板治疗缩短至3 - 6个月，特别是在植入新一代DES后，以提高成本效益。然而，临床结果并不一致，且关于新一代DES的数据有限。在本报告中，总结了最近发表的关于DES植入后双联抗血小板最佳疗程的重要关键报告。

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本文引用的文献

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Optimal duration of dual antiplatelet therapy after drug-eluting stent implantation: a randomized, controlled trial.药物洗脱支架置入后双联抗血小板治疗的最佳持续时间：一项随机对照试验。
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Pathways of platelet activation and unexplained clopidogel variability: causes of poor response to clopidogrel.血小板激活途径与氯吡格雷的不明变异性：氯吡格雷反应不佳的原因
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Clinical outcome following stringent discontinuation of dual antiplatelet therapy after 12 months in real-world patients treated with second-generation zotarolimus-eluting resolute and everolimus-eluting Xience V stents: 2-year follow-up of the randomized TWENTE trial.真实世界中使用第二代佐他莫司洗脱 Resolute 支架和依维莫司洗脱 Xience V 支架治疗的患者，12 个月后严格停止双联抗血小板治疗的临床结果：TWENTE 随机试验的 2 年随访。
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Int J Cardiol. 2013 Oct 3;168(3):2579-87. doi: 10.1016/j.ijcard.2013.03.047. Epub 2013 Apr 13.
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A randomized controlled trial in second-generation zotarolimus-eluting Resolute stents versus everolimus-eluting Xience V stents in real-world patients: the TWENTE trial.在真实世界患者中，第二代佐他莫司洗脱 Resolute 支架与依维莫司洗脱 Xience V 支架的随机对照试验：TWENTE 试验。
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Six-month versus 12-month dual antiplatelet therapy after implantation of drug-eluting stents: the Efficacy of Xience/Promus Versus Cypher to Reduce Late Loss After Stenting (EXCELLENT) randomized, multicenter study.药物洗脱支架植入术后 6 个月与 12 个月双联抗血小板治疗：西罗莫司洗脱依维莫司洗脱支架与 Cypher 支架减少支架置入后晚期管腔丢失的疗效（EXCELLENT）随机、多中心研究。
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