de Bono D
Department of Medicine, University of Leicester Medical School, UK.
Br Med Bull. 1994 Oct;50(4):904-10. doi: 10.1093/oxfordjournals.bmb.a072932.
Management of thrombosis in coronary heart disease comprises the management of acute coronary thrombosis presenting as myocardial infarction or as unstable angina, the use of anticoagulant therapy to prevent or treat complications of myocardial infarction, and prophylaxis in patients identified as being at increased risk. Thrombolytic therapy and aspirin independently and additively reduce mortality in evolving myocardial infarction. Aspirin and heparin, but not thombolytic agents, improve outcome in unstable angina. Heparin and warfarin reduce the risk of embolism from left ventricular thrombus forming post-infarction. Aspirin has been shown to reduce the risk of further cardiovascular events or cardiac death in patients identified as at high risk. Current research is evaluating the role of antithrombins and platelet adhesion inhibitors as adjuvant therapy after thrombolysis, in unstable angina, and as heparin substitutes during coronary angioplasty, and of low dose warfarin as long-term prophylaxis in high risk patients.
冠心病血栓形成的管理包括对表现为心肌梗死或不稳定型心绞痛的急性冠状动脉血栓形成的管理、使用抗凝治疗预防或治疗心肌梗死的并发症，以及对确定为高危患者的预防。溶栓治疗和阿司匹林可独立且相加地降低进展性心肌梗死的死亡率。阿司匹林和肝素而非溶栓剂可改善不稳定型心绞痛的预后。肝素和华法林可降低梗死形成后左心室血栓形成导致的栓塞风险。已证明阿司匹林可降低高危患者发生进一步心血管事件或心脏死亡的风险。当前研究正在评估抗凝血酶和血小板黏附抑制剂在溶栓后、不稳定型心绞痛中作为辅助治疗的作用，以及在冠状动脉血管成形术中作为肝素替代品的作用，同时评估低剂量华法林作为高危患者长期预防措施的作用。
