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经皮心血管介入治疗的抗栓治疗:从冠状动脉疾病到结构性心脏病介入治疗

Antithrombotic Therapy for Percutaneous Cardiovascular Interventions: From Coronary Artery Disease to Structural Heart Interventions.

作者信息

Caracciolo Alessandro, Mazzone Paolo, Laterra Giulia, Garcia-Ruiz Victoria, Polimeni Alberto, Galasso Salvatore, Saporito Francesco, Carerj Scipione, D'Ascenzo Fabrizio, Marquis-Gravel Guillaume, Giustino Gennaro, Costa Francesco

机构信息

Department of Clinical and Experimental Medicine, Policlinic "G. Martino", University of Messina, 98100 Messina, Italy.

UGC del Corazón, Servicio de Cardiología, Hospital Clínico Universitario Virgen de la Victoria, 29010 Málaga, Spain.

出版信息

J Clin Med. 2019 Nov 19;8(11):2016. doi: 10.3390/jcm8112016.

Abstract

Percutaneous cardiovascular interventions have changed dramatically in recent years, and the impetus given by the rapid implementation of novel techniques and devices have been mirrored by a refinement of antithrombotic strategies for secondary prevention, which have been supported by a significant burden of evidence from clinical studies. In the current manuscript, we aim to provide a comprehensive, yet pragmatic, revision of the current available evidence regarding antithrombotic strategies in the domain of percutaneous cardiovascular interventions. We revise the evidence regarding antithrombotic therapy for secondary prevention in coronary artery disease and stent implantation, the complex interrelation between antiplatelet and anticoagulant therapy in patients undergoing percutaneous coronary intervention with concomitant atrial fibrillation, and finally focus on the novel developments in the secondary prevention after structural heart disease intervention. A special focus on treatment individualization is included to emphasize risk and benefits of each therapeutic strategy.

摘要

近年来,经皮心血管介入治疗发生了巨大变化,新技术和设备的迅速应用推动了这一领域的发展,与此同时,二级预防的抗栓策略也得到了完善,临床研究的大量证据为其提供了支持。在本手稿中,我们旨在对经皮心血管介入领域抗栓策略的现有证据进行全面而务实的修订。我们修订了关于冠状动脉疾病和支架植入二级预防抗栓治疗的证据,以及伴有心房颤动的经皮冠状动脉介入治疗患者抗血小板和抗凝治疗之间的复杂相互关系,最后聚焦于结构性心脏病介入治疗后二级预防的新进展。特别强调了治疗个体化,以突出每种治疗策略的风险和益处。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5a7b/6912795/bcb5265bef90/jcm-08-02016-g001.jpg

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