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冠状动脉疾病中的双联抗血小板治疗:美国心脏病学会/美国心脏协会2016年与欧洲心脏病学会2017年指南比较

Dual Antiplatelet Therapy in Coronary Artery Disease: Comparison Between ACC/AHA 2016 and ESC 2017 Guidelines.

作者信息

Floyd Christopher N

机构信息

King's College London British Heart Foundation Centre, School of Cardiovascular Medicine and Sciences, Department of Clinical Pharmacology, London, UK.

Biomedical Research Centre, Clinical Research Facility, Guy's and St Thomas' NHS Foundation Trust, London, UK.

出版信息

Eur Cardiol. 2020 Feb 26;15:1-3. doi: 10.15420/ecr.2019.09. eCollection 2020 Feb.

Abstract

Dual antiplatelet therapy (DAPT) is integral to the management of coronary artery disease (CAD) but there remains uncertainty as to the optimal approach for balancing an individual's risk of atherothrombotic events versus their risk of bleeding complications. A myriad of clinical trials have investigated how factors such as antiplatelet selection or duration of treatment can affect outcomes in both stable CAD and acute coronary syndromes. To aid clinicians in the challenge of applying trial findings to the circumstances of individual patients, the American College of Cardiology/American Heart Association and European Society of Cardiology have released focused updates on prescribing DAPT in CAD. While the two guidelines agree on many issues, there are some differences in the recommendations. This article highlights those differences and provides comment on their aetiology.

摘要

双联抗血小板治疗(DAPT)是冠状动脉疾病(CAD)管理的重要组成部分,但在平衡个体动脉粥样硬化血栓形成事件风险与出血并发症风险的最佳方法上仍存在不确定性。大量临床试验研究了抗血小板药物选择或治疗持续时间等因素如何影响稳定型CAD和急性冠状动脉综合征的预后。为帮助临床医生应对将试验结果应用于个体患者情况的挑战,美国心脏病学会/美国心脏协会和欧洲心脏病学会发布了关于CAD中开具DAPT的重点更新内容。虽然这两个指南在许多问题上达成了一致,但在推荐意见上仍存在一些差异。本文重点介绍了这些差异,并对其病因进行了评论。

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引用本文的文献

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Dual Antiplatelet Therapy in Coronary Artery Disease.冠状动脉疾病中的双联抗血小板治疗
Cardiol Ther. 2020 Dec;9(2):349-361. doi: 10.1007/s40119-020-00197-0. Epub 2020 Aug 17.

本文引用的文献

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International Expert Consensus on Switching Platelet P2Y Receptor-Inhibiting Therapies.国际血小板 P2Y 受体抑制剂转换治疗专家共识。
Circulation. 2017 Nov 14;136(20):1955-1975. doi: 10.1161/CIRCULATIONAHA.117.031164. Epub 2017 Oct 30.
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The epidemiology of cardiovascular disease in the UK 2014.2014年英国心血管疾病流行病学
Heart. 2015 Aug;101(15):1182-9. doi: 10.1136/heartjnl-2015-307516. Epub 2015 Jun 3.

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