Saito Yuichi, Kobayashi Yoshio
Department of Cardiovascular Medicine Chiba University Graduate School of Medicine Chiba Japan.
J Arrhythm. 2024 Aug 8;40(5):1108-1114. doi: 10.1002/joa3.13128. eCollection 2024 Oct.
Patients with atrial fibrillation (AF) often develop acute coronary syndrome and undergo percutaneous coronary intervention (PCI), and vice versa. Acute coronary syndrome and PCI mandate the use of dual antiplatelet therapy, while oral anticoagulation is recommended in patients with AF to mitigate thromboembolic risks. Clinical evidence concerning antithrombotic treatment in patients with AF and PCI has been accumulated, but when combined, the therapeutic strategy becomes complex. Although triple therapy, a combination of oral anticoagulation with dual antiplatelet therapy, has been used for patients with AF undergoing PCI as an initial antithrombotic strategy, less intensive regimens may be associated with a lower rate of bleeding without an increased risk in thrombotic events. This narrative review article summarizes currently available evidence of antithrombotic therapy in patients with AF undergoing PCI.
心房颤动（AF）患者常并发急性冠状动脉综合征并接受经皮冠状动脉介入治疗（PCI），反之亦然。急性冠状动脉综合征和PCI均需使用双联抗血小板治疗，而AF患者推荐口服抗凝以降低血栓栓塞风险。关于AF合并PCI患者抗栓治疗的临床证据已有积累，但联合使用时治疗策略变得复杂。尽管三联疗法（口服抗凝与双联抗血小板治疗联合）已被用于接受PCI的AF患者作为初始抗栓策略，但强度较低的方案可能在不增加血栓形成事件风险的情况下降低出血发生率。这篇叙述性综述文章总结了目前关于接受PCI的AF患者抗栓治疗的现有证据。
