Lister K, Louis Simonet M
Rev Med Suisse. 2015 Oct 14;11(490):1904, 1906-8.
In patients with both stable coronary disease and atrial fibrillation, a baseline treatment of aspirin and an oral anticoagulant is often prescribed due to the proven benefits of each therapy on cardiovascular and thromboembolic events and mortality. However, recent cohort studies in this population have shown that adding aspirin to an oral anticoagulant is not associated with a reduction in recurrence of coronary or thromboembolic events, but significantly increases the bleeding risk. In these patients, in particular when their bleeding risk is high, aspirin withdrawal may be considered.
在患有稳定型冠心病和心房颤动的患者中,由于每种治疗方法对心血管和血栓栓塞事件及死亡率都有已证实的益处,通常会开出阿司匹林和口服抗凝剂的基础治疗方案。然而,最近针对该人群的队列研究表明,在口服抗凝剂基础上加用阿司匹林与冠状动脉或血栓栓塞事件复发率降低无关,但会显著增加出血风险。在这些患者中,尤其是当他们的出血风险较高时,可以考虑停用阿司匹林。