摘要
约20%～30%的心房颤动患者合并冠心病,其中至少5%～7%行冠状动脉支架置入治疗。心房颤动合并冠心病患者支架置入术后需要同时抗凝和抗血小板治疗,平衡血栓事件与出血风险是制定治疗方案的关键。多项临床研究提到,口服抗凝药联合一种抗血小板药将成为三联抗栓治疗的替代治疗方案,但由于样本量不足,尚不能支撑临床决策和个人抗栓方案的制定。大规模、多中心、随机、双盲、高质量的临床试验仍有待出现。
About 20%to 30%of patients with atrial fibrillation(AF)have coronary heart disease,of which at least 5%to 7%undergo coronary stenting.Anticoagulant and antiplatelet therapy are required for patients with AF undergoing percutaneous coronary intervention(PCI)and stenting(PCI-S).The balance between reducing the risk of thromboembolic events and bleeding is the key point for therapeutic decision making in these patients.Nowadays,several clinical trials have presented dual therapy with OAC and clopidogrel may be an alternative to triple therapy in patients with AF and acute coronary syndrome and/or coronary intervention,but due to insufficient sample size,clinical decision making and personal antithrombotic regimens are not yet supported.It remains challenging to find the best therapy for persistent or permanent AF patients after PCI-S.
作者
杨璐
吴永全
Yang Lu;Wu Yongquan(Department of Cardiology 3A,Capital Medical University Affiliated Beijing Anzhen Hospital,Beijing 100029,China)
出处
《中国心血管杂志》
2019年第2期183-186,共4页
Chinese Journal of Cardiovascular Medicine
基金
国家自然科学基金项目(81570220)~~
关键词
心房颤动
冠状动脉疾病
抗凝药
血小板聚集抑制剂
华法林
Atrial fibrillation
Coronary artery disease
Anticoagulants
Platelet aggregation inhibitors
Warfarin
