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外周动脉疾病的抗血栓治疗:将证据转化为实践。

Antithrombotic Therapy in Peripheral Artery Disease: Generating and Translating Evidence Into Practice.

机构信息

Department Heart Center and Duke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina.

Department Heart Center and Duke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina.

出版信息

J Am Coll Cardiol. 2018 Jan 23;71(3):352-362. doi: 10.1016/j.jacc.2017.11.021.

Abstract

Atherosclerotic cardiovascular (CV) disease remains a major health concern affecting more than 200 million adults worldwide, and lower extremity peripheral artery disease (PAD) is associated with significant morbidity and mortality. Treatment strategies to reduce the burden of major adverse CV events and limb events have mainly involved the use of antiplatelet and statin medications. Unlike other types of atherosclerotic CV disease, the evidence base is not well developed for therapies in patients with PAD. Recently, studies from subgroups of patients with PAD and a large clinical trial of PAD patients have been published, signaling a burgeoning interest in studying this higher risk population. This review outlines the inherent CV risks of patients with PAD, risk reduction strategies, emerging clinical trial data, and opportunities for the CV community to generate evidence in real-world settings and translate evidence into practice as new therapies become available.

摘要

动脉粥样硬化性心血管(CV)疾病仍然是一个主要的健康关注点,影响着全球超过 2 亿成年人,下肢外周动脉疾病(PAD)与显著的发病率和死亡率相关。降低主要不良 CV 事件和肢体事件负担的治疗策略主要涉及使用抗血小板和他汀类药物。与其他类型的动脉粥样硬化性 CV 疾病不同,PAD 患者治疗的证据基础尚未充分发展。最近,PAD 患者亚组和 PAD 患者大型临床试验的研究已经发表,表明人们对研究这一高危人群的兴趣日益浓厚。这篇综述概述了 PAD 患者的固有 CV 风险、降低风险策略、新兴临床试验数据,以及心血管社区在新疗法问世时如何在真实环境中生成证据并将证据转化为实践的机会。

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