冠状动脉疾病中的双联抗血小板治疗
Dual Antiplatelet Therapy in Coronary Artery Disease.
作者信息
Sharma Raghav, Kumar Prathap, Prashanth S P, Belagali Yogesh
机构信息
Interventional Cardiologist, Meditrina Hospital Civil Hospital, Ambala Cantt, Haryana, India.
Interventional Cardiologist, Meditrina Hospital, Ayoor road, Ayathil, Kollam, Kerala, India.
出版信息
Cardiol Ther. 2020 Dec;9(2):349-361. doi: 10.1007/s40119-020-00197-0. Epub 2020 Aug 17.
Abstract
Acute coronary syndrome (ACS) is principally driven by platelet aggregation. Dual antiplatelet therapy (DAPT) has demonstrated a reduction in recurrent ischemic events. The newer antiplatelets ticagrelor and prasugrel have demonstrated superiority over clopidogrel. While prasugrel demonstrated benefit in patients scheduled for percutaneous intervention (PCI), benefits of ticagrelor were seen irrespective of the treatment strategy. Current guidelines recommend the use of DAPT for 1 year in all patients with ACS. Ticagrelor 60 mg is recommended for up to 3 years in high-risk patients. DAPT and Predicting Bleeding Complications in Patients Undergoing Stent Implantation and Subsequent Dual Antiplatelet Therapy (PRECISE DAPT) scores are tools to support decision-making in deciding duration of dual antiplatelet therapy.
摘要
急性冠状动脉综合征（ACS）主要由血小板聚集驱动。双联抗血小板治疗（DAPT）已证明可减少复发性缺血事件。新型抗血小板药物替格瑞洛和普拉格雷已证明优于氯吡格雷。虽然普拉格雷在计划进行经皮冠状动脉介入治疗（PCI）的患者中显示出益处，但无论治疗策略如何，替格瑞洛均显示出益处。当前指南建议所有ACS患者使用DAPT 1年。高危患者推荐使用替格瑞洛60 mg长达3年。DAPT和支架植入及后续双联抗血小板治疗患者出血并发症预测（PRECISE DAPT）评分是支持决定双联抗血小板治疗持续时间的决策工具。
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