Kaufmann Christoph C, Muthspiel Marie, Lunzer Laura, Pogran Edita, Zweiker David, Burger Achim Leo, Wojta Johann, Huber Kurt
3rd Medical Department with Cardiology and Intensive Care Medicine, Klinik Ottakring (Wilhelminenhospital), A-1160 Vienna, Austria.
Faculty of Medicine, Sigmund Freud University, A-1020 Vienna, Austria.
J Clin Med. 2024 Apr 17;13(8):2313. doi: 10.3390/jcm13082313.
Acute coronary syndrome (ACS) remains a major challenge in clinical practice, requiring rapid and effective antithrombotic treatment to mitigate adverse ischemic events while minimizing the risk of bleeding. In recent years, results from several clinical trials addressing this issue through various approaches have substantially improved the treatment landscape for patients presenting with ACS. The emergence of new, potent P2Y inhibitors has significantly enhanced thrombotic risk reduction and different strategies for de-escalating and shortening dual antiplatelet therapy (DAPT) have demonstrated promising outcomes in reducing bleeding rates. Furthermore, data from ongoing trials focusing on novel therapeutic agents and investigating alternative treatment strategies to optimize outcomes for ACS patients are expected in the next few years. In this review, we summarize the current knowledge and emphasize the critical role of individualized treatment approaches tailored to patient-specific risk factors and individual clinical scenarios.
急性冠状动脉综合征（ACS）仍是临床实践中的一项重大挑战，需要迅速有效的抗栓治疗，以减轻不良缺血事件，同时将出血风险降至最低。近年来，多项通过不同方法解决这一问题的临床试验结果，已大幅改善了ACS患者的治疗格局。新型强效P2Y抑制剂的出现显著增强了血栓形成风险的降低效果，而不同的双抗血小板治疗（DAPT）降阶梯和缩短疗程策略，在降低出血率方面已显示出有前景的结果。此外，预计未来几年将有来自正在进行的试验的数据，这些试验聚焦于新型治疗药物，并研究优化ACS患者治疗效果的替代治疗策略。在本综述中，我们总结了当前的知识，并强调针对患者特定风险因素和个体临床情况的个体化治疗方法的关键作用。
