From the Thrombosis and Atherosclerosis Research Institute and Department of Medicine, McMaster University, Hamilton, Ontario, Canada.
Arterioscler Thromb Vasc Biol. 2019 Jan;39(1):7-12. doi: 10.1161/ATVBAHA.118.310960.
Thrombosis remains a major cause of morbidity and mortality. Consequently, advances in antithrombotic therapy are needed to reduce the disease burden. This article focuses on 2 such advances. First, the prevention of atherothrombosis in patients with coronary or peripheral artery disease, which has been enhanced by the finding that the combination of low-dose rivaroxaban plus aspirin is superior to aspirin alone for prevention of recurrent ischemic events. However, this benefit comes at the cost of increased bleeding albeit not fatal bleeding. To overcome this problem, the second advance is the identification of factor XI as a target for new anticoagulants that are potentially safer than those currently available.
血栓仍然是发病率和死亡率的主要原因。因此,需要在抗血栓治疗方面取得进展,以减轻疾病负担。本文重点介绍了两项此类进展。首先,通过发现小剂量利伐沙班加阿司匹林联合治疗优于单独使用阿司匹林预防复发性缺血事件,增强了对冠心病或外周动脉疾病患者的抗动脉粥样硬化血栓形成作用。然而,这种益处是以增加出血为代价的,尽管不是致命性出血。为了解决这个问题,第二项进展是确定因子 XI 作为新型抗凝剂的靶点,这些抗凝剂可能比现有抗凝剂更安全。