Chousou Panagiota Anna, Pugh Peter J
Department of Cardiology, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge CB2 0QQ, UK.
Future Cardiol. 2018 Mar;14(2):151-164. doi: 10.2217/fca-2017-0044. Epub 2017 Dec 11.
A substantial proportion of patients who undergo cardiac device implantation receive oral anticoagulation to prevent thromboembolism or antiplatelets to prevent thrombotic events. Anticoagulation and antiplatelets increase the risk of hemorrhagic complications, while discontinuation may increase thromboembolic risk and thrombotic events. With the introduction of non-vitamin K antagonist oral anticoagulant agents and the newer antiplatelet agents such as prasugrel or ticagrelor, the perioperative management of patients has become more challenging. In this article, we review the recent trials and meta-analysis and describe the available evidence, as well as the current recommendations in order to inform best practice. We also reinforce the importance of further trials in this complex and rapidly evolving area.
接受心脏装置植入的患者中有很大一部分接受口服抗凝药以预防血栓栓塞或抗血小板药以预防血栓形成事件。抗凝和抗血小板治疗会增加出血并发症的风险，而停药可能会增加血栓栓塞风险和血栓形成事件。随着非维生素K拮抗剂口服抗凝剂以及新型抗血小板药物如普拉格雷或替格瑞洛的引入，患者的围手术期管理变得更具挑战性。在本文中，我们回顾了近期的试验和荟萃分析，描述了现有证据以及当前建议，以便为最佳实践提供参考。我们还强调了在这个复杂且快速发展的领域进行进一步试验的重要性。
