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《2018年台湾急性冠状动脉综合征抗血小板治疗不良反应管理专家共识》

2018 Expert Consensus on the Management of Adverse Effects of Antiplatelet Therapy for Acute Coronary Syndrome in Taiwan.

作者信息

Li Yi-Heng, Fang Chih-Yuan, Hsieh I-Chang, Huang Wei-Chun, Lin Tsung-Hsien, Sung Shih-Hsien, Chiu Chiung-Zuan, Wu Chiung-Jen, Shyu Kou-Gi, Chang Po-Yuan, Fang Ching-Chang, Lu Tse-Min, Chen Ching-Pei, Tai Wei-Chen, Sheu Chau-Chyun, Wei Kai-Che, Huang Yi-Hsiu, Wu Hsing-Mei, Hwang Juey-Jen Hwang

机构信息

Division of Cardiology, Department of Internal Medicine, National Cheng Kung University Hospital and College of Medicine, Tainan.

Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung.

出版信息

Acta Cardiol Sin. 2018 May;34(3):201-210. doi: 10.6515/ACS.201805_34(3).20180302A.

Abstract

Antiplatelet therapy is a key component in the treatment of acute coronary syndrome (ACS). The management of ACS has evolved considerably over recent years with the development of new and more potent antiplatelet agents. Clinical trials on ACS have demonstrated that potent antiplatelet agents can more effectively reduce cardiovascular events. However, there is a tipping point between safety and efficacy, beyond which the risk of bleeding and other adverse effects can outweigh the benefits of antiplatelet therapy. Striking a balance between safety and efficacy remains a major challenge. A consensus meeting of an expert panel composed of Taiwanese experts was held to provide recommendations for the management of adverse effects in patients with ACS receiving antiplatelet therapy. The common adverse effects of antiplatelet therapy include upper gastrointestinal bleeding, ecchymosis, hematuria, epistaxis and ticagrelor-related dyspnea. In this study, a literature review of these adverse events was performed and recommendations for the management were made.

摘要

抗血小板治疗是急性冠状动脉综合征(ACS)治疗的关键组成部分。近年来,随着新型且更有效的抗血小板药物的研发,ACS的管理有了很大进展。关于ACS的临床试验表明,强效抗血小板药物能更有效地减少心血管事件。然而,在安全性和有效性之间存在一个临界点,超过这个点,出血风险和其他不良反应可能超过抗血小板治疗的益处。在安全性和有效性之间取得平衡仍然是一项重大挑战。由台湾专家组成的专家小组召开了一次共识会议,为接受抗血小板治疗的ACS患者的不良反应管理提供建议。抗血小板治疗的常见不良反应包括上消化道出血、瘀斑、血尿、鼻出血和替格瑞洛相关的呼吸困难。在本研究中,对这些不良事件进行了文献综述并提出了管理建议。

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