Département de Cardiologie, CHU Timone, Marseille, France; Aix-Marseille Université, Faculté de Médecine, Marseille, France.
Department of Cardiology, Onze Lieve Vrouwe Gasthuis, Amsterdam, Netherlands.
Lancet. 2017 Aug 19;390(10096):810-820. doi: 10.1016/S0140-6736(17)31936-0.
For relief of coronary obstruction, percutaneous coronary intervention has become a standard-of-care procedure over the past 40 years. Nonetheless, optimal outcomes after coronary stenting require careful attention to antithrombotic therapy. This review aims to summarise the current available evidence and discusses how to integrate scientific knowledge into clinical decisions. In recent years, improvement and modifications of drugs and devices have changed the field tremendously, and substantially benefitted patient outcomes. The key challenge of how to provide optimal protection against thrombotic events without excessive increases in bleeding risk has remained the same for decades. Alternative strategies with new drugs, both antiplatelet and anticoagulant agents, and new coronary stents will continue the journey to achieve this ultimate goal.
在过去的 40 年中,经皮冠状动脉介入治疗已经成为缓解冠状动脉阻塞的标准治疗方法。然而,冠状动脉支架置入术后的最佳效果需要仔细关注抗血栓治疗。本综述旨在总结目前可用的证据,并讨论如何将科学知识融入临床决策。近年来,药物和器械的改进和修改极大地改变了这一领域,并极大地改善了患者的预后。几十年来,如何在不增加过度出血风险的情况下提供最佳的抗血栓事件保护仍然是一个关键的挑战。用新型药物(抗血小板和抗凝药物)和新型冠状动脉支架的替代策略将继续朝着实现这一最终目标的方向前进。