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经皮冠状动脉介入治疗的心房颤动患者的抗血栓治疗。

Antithrombotic Therapy in Patients with Atrial Fibrillation Undergoing Percutaneous Coronary Intervention.

机构信息

The Zena and Michael A. Wiener Cardiovascular Institute, The Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, New York, NY 10029, USA.

The Zena and Michael A. Wiener Cardiovascular Institute, The Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, New York, NY 10029, USA.

出版信息

Cardiol Clin. 2020 Nov;38(4):551-561. doi: 10.1016/j.ccl.2020.07.006. Epub 2020 Sep 17.

Abstract

Patients with atrial fibrillation who undergo percutaneous coronary intervention with drug-eluting stent implantation often require oral anticoagulation (OAC) and antiplatelet therapies. Triple antithrombotic therapy (OAC, a P2Y-receptor inhibitor, and aspirin) has been the default antithrombotic strategy. Evidence from randomized trials indicates, however, that a dual antithrombotic therapy strategy (OAC plus a P2Y-receptor inhibitor) reduces bleeding risk without increasing the risk of ischemic events. This review provides an overview of advancements in this field as well as European and North American guidelines and consensus documents to inform clinical decision making around antithrombotic therapies for patients with atrial fibrillation who undergo percutaneous coronary intervention.

摘要

经皮冠状动脉介入治疗(PCI)置入药物洗脱支架的房颤患者通常需要口服抗凝(OAC)和抗血小板治疗。三联抗栓治疗(OAC、P2Y12 受体抑制剂和阿司匹林)一直是默认的抗栓策略。然而,随机试验的证据表明,双联抗栓治疗策略(OAC 加 P2Y12 受体抑制剂)可降低出血风险而不增加缺血事件风险。本综述介绍了这一领域的最新进展以及欧洲和北美的指南和共识文件,为房颤患者 PCI 后抗栓治疗的临床决策提供信息。

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