心肌梗死后急性缺血性卒中伴或不伴心房颤动患者的口服抗凝和抗血小板治疗管理
Management of Oral Anticoagulation and Antiplatelet Therapy in Post-Myocardial Infarction Patients with Acute Ischemic Stroke with and without Atrial Fibrillation.
作者信息
Pezzella Francesca Romana, Mangiardi Marilena, Ferrante Mario, Fabiano Sebastiano, Anticoli Sabrina, Pennacchi Fabrizio Giorgio, Urso Antonella, De Luca Leonardo, Caso Valeria
机构信息
Stroke Unit, Department of Neuroscience, San Camillo-Forlanini Hospital, 00152 Rome, Italy.
Unit of Neurology, Neurophysiology, Neurobiology, Department of Medicine, University Campus Bio-Medico, 00128 Rome, Italy.
出版信息
J Clin Med. 2022 Jul 4;11(13):3894. doi: 10.3390/jcm11133894.
Abstract
The association between atrial fibrillation (AF), acute coronary syndrome (ACS), and stroke is a complex scenario in which the assessment of both thrombotic and hemorrhagic risk is necessary for scheduling an individually tailored therapeutic plan. Recent clinical trials investigating new antithrombotic drugs and dual and triple pathways in high-risk cardiovascular patients have revealed a new therapeutic scenario. In this paper, we review the burden of ischemic stroke (IS) in patients post-myocardial infarction with and without atrial fibrillation and the possible therapeutic strategies from a stroke point of view.
摘要
心房颤动（AF）、急性冠状动脉综合征（ACS）和中风之间的关联是一个复杂的情况，在制定个性化治疗方案时，有必要对血栓形成和出血风险进行评估。最近针对高危心血管患者的新型抗血栓药物以及双重和三重途径的临床试验揭示了一种新的治疗方案。在本文中，我们从中风的角度回顾了心肌梗死后伴或不伴有心房颤动患者的缺血性中风（IS）负担以及可能的治疗策略。
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2
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