Bristol Heart Institute, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, England.
Weston General Hospital, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK.
Curr Cardiol Rev. 2023;19(1):e120522204669. doi: 10.2174/1573403X18666220512142019.
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has been demonstrated as a major risk factor in inducing coronary stent thrombosis due to its propensity to create a pro-thrombotic state. This review explores the mechanisms that may contribute to the increased thrombosis risk seen in COVID-19. Furthermore, we discuss the patient and haematological factors that predispose to an increased risk of stent thrombosis, as well as the role of certain antiplatelet and anticoagulation therapies, including ticagrelor and enoxaparin, that may reduce the likelihood and severity of in-stent thrombosis, in SARS-CoV-2 infection. To counter the proinflammatory and pro-thrombotic state shown in COVID-19, anti-thrombotic therapy in the future may be optimised using point-of-care platelet inhibition testing and inflammation-modifying therapies. Large-scale randomised trials with long-term follow-up are increasingly necessary to assess the intersection of COVID-19 and stent optimisation as well as the reduction of stent thrombosis after drug-eluting stent (DES) implantation.
严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）感染已被证明是导致冠状动脉支架血栓形成的一个主要危险因素，因为它容易导致血栓形成状态。这篇综述探讨了可能导致 COVID-19 中血栓形成风险增加的机制。此外，我们讨论了使支架血栓形成风险增加的患者和血液学因素，以及某些抗血小板和抗凝治疗的作用，包括替格瑞洛和依诺肝素，这些可能降低 SARS-CoV-2 感染中支架内血栓形成的可能性和严重程度。为了对抗 COVID-19 中表现出的促炎和促血栓形成状态，未来的抗血栓治疗可能通过即时血小板抑制测试和炎症调节治疗来优化。越来越有必要进行大规模的随机试验和长期随访，以评估 COVID-19 和支架优化以及药物洗脱支架（DES）植入后支架血栓形成减少之间的交叉点。
