Degrauwe Sophie, Iglesias Juan F
Rev Med Suisse. 2016 May 25;12(520):1022-6, 1028-34.
The choice and optimal duration of dualantiplatelet therapy (DAPT) for the treatment of coronary artery disease (CAD) represent a challenging clinical dilemma. Antiplatelet treatment strategies are determined by the clinical setting, patient comorbidities and management strategy. While aspirin remains the cornerstone for secondary prevention of CAD, DAPT significantly reduces recurrent ischemic adverse events at the expense of an increased risk of major bleeding complications. A tailored approach based on individual ischemic and hemorrhagic risk assessment is currently recommended. This review aims to provide a contemporary overview on the current body of evidence concerning DAPT for treatment and secondary prevention of CAD with practical emphasis on current indications, choice, combination and optimal duration of antiplatelet therapy.
用于治疗冠状动脉疾病(CAD)的双联抗血小板治疗(DAPT)的选择和最佳疗程是一个具有挑战性的临床难题。抗血小板治疗策略由临床情况、患者合并症和管理策略决定。虽然阿司匹林仍然是CAD二级预防的基石,但双联抗血小板治疗以增加大出血并发症风险为代价,显著降低了复发性缺血性不良事件。目前建议采用基于个体缺血和出血风险评估的个性化方法。本综述旨在对目前关于DAPT用于CAD治疗和二级预防的证据进行当代概述,实际重点在于抗血小板治疗的当前适应证、选择、联合用药及最佳疗程。