Department of Cardiovascular Medicine, Saga University Hospital, 5-1-1 Nabeshima, Saga, 849-8501, Japan.
Cardiovascular Center, Saga Medical Center, Koseikan, Saga, Japan.
Cardiovasc Interv Ther. 2022 Apr;37(2):255-263. doi: 10.1007/s12928-022-00847-1. Epub 2022 Mar 3.
Antiplatelet therapy after percutaneous coronary intervention (PCI) has been changing in parallel with the development of drug-eluting stents (DES) and antiplatelet agents. The recommendation of dual antiplatelet therapy duration is getting shorter due to the decreased risk of stent thrombosis in new-generation DES, the use of a P2Y inhibitor as a monotherapy, and the increasing prevalence of high bleeding risk patients. Antithrombotic therapy after PCI has also changed due to the introduction of direct oral anticoagulants. Aspirin-free P2Y inhibitor monotherapy is now being evaluated in several prospective studies as a novel strategy of antiplatelet therapy after PCI. This review shows a current status and provides future perspectives for the antiplatelet therapy after PCI.
经皮冠状动脉介入治疗 (PCI) 后的抗血小板治疗与药物洗脱支架 (DES) 和抗血小板药物的发展并行变化。由于新一代 DES 中支架血栓形成风险降低、P2Y 抑制剂作为单药使用以及高出血风险患者的患病率增加，双联抗血小板治疗时间的建议越来越短。由于直接口服抗凝剂的引入，PCI 后的抗血栓治疗也发生了变化。目前正在几项前瞻性研究中评估无阿司匹林的 P2Y 抑制剂单药治疗作为 PCI 后抗血小板治疗的新策略。本综述展示了 PCI 后抗血小板治疗的现状，并提供了未来展望。
