Department of Cardiovascular and Thoracic Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome.
Division of Cardiology, University of Florida College of Medicine, Jacksonville, Florida, USA.
Curr Opin Cardiol. 2021 Jul 1;36(4):390-396. doi: 10.1097/HCO.0000000000000879.
Antiplatelet therapy is key to reduce systemic and local thrombotic events among patients undergoing percutaneous coronary interventions (PCI). Antiplatelet treatment regimens have been subject to continuous changes over the years, with a dual antiplatelet therapy (DAPT), consisting of aspirin and a P2Y12 inhibitor representing the cornerstone of treatment in these patients.
The need for less aggressive antithrombotic drugs to prevent local ischemic events with newer generation drug-eluting stent together with the increased understanding of the prognostic relevance of bleeding events in PCI patients, have prompted investigations aimed at identifying antiplatelet treatment regimens associated with a more favorable balance between ischemic and bleeding risks. Several key randomized controlled trials (RCTs) on antiplatelet regimens in patients undergoing PCI have been recently reported resulting in updates in practice guidelines.
This manuscript provides an overview of the advancements in the field deriving from key RCTs on antiplatelet regimens in patients undergoing PCI.
抗血小板治疗是减少经皮冠状动脉介入治疗(PCI)患者全身和局部血栓事件的关键。多年来,抗血小板治疗方案不断变化,双联抗血小板治疗(DAPT)由阿司匹林和 P2Y12 抑制剂组成,是这些患者治疗的基石。
为了预防新一代药物洗脱支架引起的局部缺血事件,需要使用不太激进的抗血栓药物,再加上对 PCI 患者出血事件预后相关性的认识不断提高,促使人们研究旨在确定与缺血和出血风险之间更有利平衡相关的抗血小板治疗方案。最近报告了几项关于 PCI 患者抗血小板治疗方案的关键随机对照试验(RCT),从而更新了实践指南。
本文概述了 PCI 患者抗血小板治疗方案的关键 RCT 带来的该领域的进展。