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心血管疾病的当前抗血栓治疗:全面综述

Current Antithrombotic Treatments for Cardiovascular Diseases: A Comprehensive Review.

作者信息

Galanti Kristian, Di Marino Mario, Mansour Davide, Testa Sabrina, Rossi Davide, Scollo Claudio, Magnano Roberta, Pezzi Laura, D'Alleva Alberto, Forlani Daniele, Vitulli Piergiusto, Paloscia Leonardo, Ricci Fabrizio, Renda Giulia, Gallina Sabina, Di Marco Massimo

机构信息

Department of Neuroscience, Imaging and Clinical Sciences, G. D'Annunzio University of Chieti-Pescara, 66100 Chieti, Italy.

University Cardiology Division, Heart Department, "SS Annunziata" Polyclinic University Hospital, 66100 Chieti, Italy.

出版信息

Rev Cardiovasc Med. 2024 Aug 8;25(8):281. doi: 10.31083/j.rcm2508281. eCollection 2024 Aug.

Abstract

Antithrombotic therapies (ATT) play a pivotal role in the management of cardiovascular diseases, aiming to prevent ischemic events while maintaining a delicate balance with the patient's bleeding risk. Typically, ATT can be classified into antiplatelet and anticoagulant therapies. Their application spans a broad spectrum of cardiovascular conditions, ranging from ischemic heart disease to atrial fibrillation, encompassing venous thromboembolisms and innovative structural interventional cardiology procedures. The global burden of cardiovascular diseases is steadily increasing, often giving rise to overlapping clinical presentations. Accordingly, the adoption of combined pharmacological approaches becomes imperative, potentially disrupting the delicate equilibrium between ischemic and bleeding risk, thus leading to nuanced pharmacotherapeutic pathways. In this context, contemporary investigations strive to identify a convergence point that optimizes the duration of medical therapy while addressing the need for antithrombotic effects, especially in the context of ischemic heart disease. This review aims to comprehensively revisit the main antithrombotic strategies in cardiovascular diseases, with the intention of enhancing a systematic approach which is key for the effective clinical management of these patients. Also, the review will examine the most impactful studies that have established the groundwork for current scientific evidence, with acknowledgement of special populations. Finally, we will cast a gaze into the future of this dynamic and evolving research field, exploring forthcoming perspectives and advancements.

摘要

抗栓治疗(ATT)在心血管疾病管理中发挥着关键作用,旨在预防缺血性事件,同时与患者的出血风险保持微妙平衡。通常,ATT可分为抗血小板治疗和抗凝治疗。其应用涵盖广泛的心血管疾病,从缺血性心脏病到心房颤动,包括静脉血栓栓塞以及创新性的结构性介入心脏病学手术。心血管疾病的全球负担正在稳步增加,常常导致临床表现重叠。因此,采用联合药物治疗方法变得势在必行,这可能会打破缺血风险和出血风险之间的微妙平衡,从而导致细微的药物治疗途径。在这种背景下,当代研究努力寻找一个交汇点,以优化药物治疗的持续时间,同时满足抗栓效果的需求,尤其是在缺血性心脏病的情况下。本综述旨在全面回顾心血管疾病中的主要抗栓策略,以加强一种系统方法,这是有效临床管理这些患者的关键。此外,该综述将审视为当前科学证据奠定基础的最具影响力的研究,并关注特殊人群。最后,我们将展望这个动态发展的研究领域的未来,探索即将出现的观点和进展。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c0ca/11366999/8c927d01ea27/2153-8174-25-8-281-g1.jpg

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