Schäfer A, Bauersachs J
Klinik für Kardiologie und Angiologie, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30659, Hannover, Deutschland.
Herz. 2018 May;43(3):222-229. doi: 10.1007/s00059-017-4657-z.
Single antiplatelet therapy (SAPT) using predominantly acetylsalicylic acid (ASA) is the baseline anti-thrombotic therapy in primary as well as secondary prevention of atherosclerotic disease. Dual antiplatelet therapy (DAPT) is the cornerstone of maintenance medication following elective percutaneous coronary interventions or acute coronary syndromes (ST elevation myocardial infarction, non-ST elevation myocardial infarction and unstable angina pectoris). In the past the duration of DAPT in particular has been frequently discussed. Current recommendations, such as the "Focused Update DAPT 2017" of the European Society of Cardiology (ESC) emphasize the importance of strategies aiming to reduce an increased risk of bleeding based on clinical predictors. In this case older age is an important factor relevant for bleeding. In this article, the evidence for SAPT or DAPT is summarized with a special focus on patients aged ≥75 years.
主要使用阿司匹林(ASA)的单一抗血小板治疗(SAPT)是动脉粥样硬化疾病一级和二级预防的基线抗栓治疗。双联抗血小板治疗(DAPT)是择期经皮冠状动脉介入治疗或急性冠状动脉综合征(ST段抬高型心肌梗死、非ST段抬高型心肌梗死和不稳定型心绞痛)后维持用药的基石。过去,DAPT的疗程尤其经常被讨论。当前的建议,如欧洲心脏病学会(ESC)的“2017聚焦更新DAPT”强调了基于临床预测指标旨在降低出血风险增加的策略的重要性。在这种情况下,高龄是与出血相关的一个重要因素。在本文中,总结了SAPT或DAPT的证据,特别关注年龄≥75岁的患者。