Gradolí Josep, Vidal Verónica, Brady Adrian Jb, Facila Lorenzo
Department of Cardiology, Hospital General Universitario, University of Valencia Valencia, Spain.
Department of Cardiology, Glasgow Royal Infirmary Glasgow, UK.
Eur Cardiol. 2018 Dec;13(2):115-118. doi: 10.15420/ecr.2018.12.2.
Patients with established cardiovascular disease may suffer further cardiovascular events, despite receiving optimal medical treatment. Although platelet inhibition plays a central role in the prevention of new events, the use of anticoagulant therapies to reduce events in atheromatous disease has, until recently, been overlooked. The recent Rivaroxaban for the Prevention of Major Cardiovascular Events in Coronary or Peripheral Artery Disease (COMPASS) study showed an important reduction in cardiovascular events without increasing the risk of fatal and intracranial bleeding when using rivaroxaban, a novel oral anticoagulant, combined with aspirin. This article reviews the available evidence regarding the use of anticoagulant therapies for prevention of cardiovascular events, the results of the COMPASS study and how these results may affect patient management in everyday clinical practice.
尽管接受了最佳药物治疗，但已确诊心血管疾病的患者仍可能发生进一步的心血管事件。虽然血小板抑制在预防新事件中起着核心作用，但直到最近，使用抗凝疗法来减少动脉粥样硬化疾病中的事件一直被忽视。最近的利伐沙班用于预防冠状动脉或外周动脉疾病中的重大心血管事件（COMPASS）研究表明，在使用新型口服抗凝剂利伐沙班联合阿司匹林时，心血管事件显著减少，且不会增加致命性和颅内出血的风险。本文综述了关于使用抗凝疗法预防心血管事件的现有证据、COMPASS研究的结果以及这些结果如何影响日常临床实践中的患者管理。
