Chang Kay-Won, Arbit Boris, Hsu Jonathan C
Cardiac Electrophysiology Section, Division of Cardiology, Department of Medicine, University of California, San Diego, La Jolla, CA 92037, United States.
Cardiac Electrophysiology Section, Division of Cardiology, Department of Medicine, University of California, San Diego, La Jolla, CA 92037, United States.
Int J Cardiol. 2017 Sep 15;243:263-269. doi: 10.1016/j.ijcard.2017.05.119. Epub 2017 Jun 2.
Atrial fibrillation and coronary artery disease are common comorbidities with increasing incidences worldwide. About 5-15% of atrial fibrillation patients will require coronary stenting at some point in their lives, which necessitates dual antiplatelet therapy with aspirin and a PY antagonist. Triple therapy refers to the clinical scenario in which a patient is prescribed aspirin, PY antagonist, and oral anticoagulant, usually in the setting of atrial fibrillation. Current guidelines on atrial fibrillation do not offer strong recommendations on triple therapy management. Furthermore, the optimal duration of dual antiplatelet therapy after percutaneous coronary intervention is evolving based on contemporary research and development of newer generation drug eluting stents, changing the necessary duration of triple therapy in patients with atrial fibrillation. This review will offer an in-depth survey of current guidelines, current evidence, and future studies regarding triple therapy in atrial fibrillation patients undergoing percutaneous coronary intervention.
心房颤动和冠状动脉疾病是全球发病率不断上升的常见合并症。约5%-15%的心房颤动患者在其一生中的某个阶段需要进行冠状动脉支架置入术，这就需要使用阿司匹林和一种P2Y拮抗剂进行双重抗血小板治疗。三联疗法是指患者通常在心房颤动的情况下，同时服用阿司匹林、P2Y拮抗剂和口服抗凝剂的临床情况。目前关于心房颤动的指南并未对三联疗法的管理给出强有力的建议。此外，基于当代新一代药物洗脱支架的研究和开发，经皮冠状动脉介入治疗后双重抗血小板治疗的最佳持续时间正在不断演变，这也改变了心房颤动患者三联疗法的必要持续时间。本综述将深入探讨关于接受经皮冠状动脉介入治疗的心房颤动患者三联疗法的当前指南、现有证据及未来研究。
