Shah Neeraj, Cox David
Department of Cardiology, Lehigh Valley Heath Network, 1250 S Cedar Crest Boulevard, Allentown, PA 18103, USA.
Department of Cardiology, Lehigh Valley Heath Network, 1250 S Cedar Crest Boulevard, Allentown, PA 18103, USA.
Interv Cardiol Clin. 2016 Oct;5(4):497-511. doi: 10.1016/j.iccl.2016.06.008. Epub 2016 Aug 10.
Anticoagulation is essential in patients with ST elevation myocardial infarction (STEMI) to prevent further thrombosis and to maintain patency of the infarct-related artery after reperfusion. The various anticoagulant medications available for use in patients with STEMI include unfractionated heparin (UFH), low-molecular-weight heparin, fondaparinux, and bivalirudin, a direct thrombin inhibitor. The authors review the current anticoagulation strategies for patients with STEMI undergoing primary percutaneous coronary intervention (PCI), fibrinolysis, or no reperfusion. The authors present the latest evidence and controversies on this topic, with a focus on bivalirudin versus UFH in the setting of primary PCI for STEMI.
对于ST段抬高型心肌梗死（STEMI）患者，抗凝治疗对于预防进一步血栓形成以及在再灌注后维持梗死相关动脉的通畅至关重要。可用于STEMI患者的各种抗凝药物包括普通肝素（UFH）、低分子量肝素、磺达肝癸钠和比伐卢定（一种直接凝血酶抑制剂）。作者回顾了接受直接经皮冠状动脉介入治疗（PCI）、纤维蛋白溶解或未进行再灌注的STEMI患者的当前抗凝策略。作者介绍了关于该主题的最新证据和争议，重点是在STEMI直接PCI背景下比伐卢定与UFH的比较。
