[1]王建强,刘 瑜,张牧秋,等.房颤伴ACS患者经皮冠状动脉介入术后抗栓研究[J].医学信息,2019,32(14):35-37.[doi:10.3969/j.issn.1006-1959.2019.14.013]
　WANG Jian-qiang,LIU Yu,ZHANG Mu-qiu,et al.Study on Antithrombotic after Percutaneous Coronary Intervention in Patients with Atrial Fibrillation and ACS[J].Journal of Medical Information,2019,32(14):35-37.[doi:10.3969/j.issn.1006-1959.2019.14.013]
点击复制

房颤伴ACS患者经皮冠状动脉介入术后抗栓研究()
分享到：

医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
32卷
期数:
2019年14期
页码:
35-37
栏目:
综述
出版日期:
2019-07-15

文章信息/Info

Title:
Study on Antithrombotic after Percutaneous Coronary Intervention in Patients with Atrial Fibrillation and ACS
文章编号:
1006-1959（2019）14-0035-03
作者:
王建强1; 刘 瑜1; 张牧秋1; 古俊楠1; 李 超2
1.首都医科大学，北京 100054； 2.北京同仁医院，北京 100176
Author(s):
WANG Jian-qiang1; LIU Yu1; ZHANG Mu-qiu1; GU Jun-nan1; LI Chao2
1.Capital Medical University,Beijing 100054,China; 2.Beijing Tongren Hospital,Beijing 100176,China
关键词:
心房颤动; 急性冠脉综合征; 经皮冠状动脉介入术; 抗栓治疗
Keywords:
Key words：Atrial fibrillation; Acute coronary syndrome; Percutaneous coronary intervention;  Antithrombotic therapy
分类号:
R541.4；R541.75
DOI:
10.3969/j.issn.1006-1959.2019.14.013
文献标志码:
A
摘要:
随着人口老龄化的加剧，心房颤动（房颤）患者越来越多，房颤伴有血栓风险，死亡率和致残率增高。部分房颤患者因合并急性冠脉综合征（ACS）需行经皮冠状动脉介入术（PCI）治疗，术后需针对房颤和ACS血栓形成的不同机制进行联合抗栓，但是如何平衡出血和血栓风险进而选择合适的策略仍是临床中一项极大的挑战。本文对近年来房颤伴ACS患者PCI术后抗栓治疗的有效性和安全性相关研究进行综述，以期指导临床个体化抗栓治疗方案的选择。
Abstract:
Abstract：With the aging of the population, more and more patients with atrial fibrillation (AF), atrial fibrillation with thrombosis risk, increased mortality and disability. Many patients with atrial fibrillation undergo percutaneous coronary intervention (PCI) for acute coronary syndrome (ACS). Postoperative antithrombotic therapy is needed for different mechanisms of atrial fibrillation and ACS thrombosis, but how to balance bleeding and the risk of thrombosis and the selection of appropriate strategies remains a major clinical challenge. This article reviews the recent advances in the efficacy and safety of antithrombotic therapy for postoperative PCI in patients with atrial fibrillation and ACS, and guides the selection of clinical individualized antithrombotic regimens.

参考文献/References:

[1]中华医学会心血管病学分会,心律失常联盟.心房颤动抗凝治疗中国专家共识[J].中华内科杂志,2012,51(11):173-177. [2]Alexopoulos D,Vlachakis P,Lekakis J.Triple Antithrombotic Therapy in Atrial Fibrillation Patients Undergoing PCI:a Fading Role[J].Cardiovasc Drugs Ther,2017,31(3):1-6. [3]Chang K,Arbit B,Hsu JC.Antithrombotic regimens in patients with atrial fibrillation and coronary artery disease after percutaneous coronary intervention:A focused review[J].International Journal of Cardiology,2017,243(5):263-269. [4]Wu N,Tong S,Xiang Y,et al.Association of hemostatic markers with atrial fibrillation:a meta-analysis and meta-regression[J].PLoS One,2015,10(4):e124716. [5]Proietti M,Lane DA,Boriani G,et al.Stroke Prevention, Evaluation of Bleeding Risk,and Anticoagulant Treatment Management in Atrial Fibrillation Contemporary International Guidelines[J].Can J Cardiol,2019,35(5):619-633. [6]Dzeshka MS,Lip GYH.Antithrombotic and Anticoagulant Therapy for Atrial Fibrillation[J].Cardiology Clinics,2016,12(2):257-271. [7]赵庆.替格瑞洛和氯吡格雷在急性冠状动脉综合征经皮冠状动脉介入治疗手术患者中的临床效果[J].医疗装备,2018,31(10):8-9. [8]Kirchhof P,Benussi S,Kotecha D,et al.2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS[J].Kardiol Pol,2016,74(12):1359-1469. [9]Flaker GC,Eikelboom JW,Shestakovska O,et al.Bleeding during treatment with aspirin versus apixaban in patients with atrial fibrillation unsuitable for warfarin:the apixaban versus acetylsalicylic acid to prevent stroke in atrial fibrillation patients who have failed or are unsuitable for vitamin K[J].Stroke,2012,43(12):3291-3297. [10]Zhu W,He W,Guo L,et al.The HAS-BLED Score for Predicting Major Bleeding Risk in Anticoagulated Patients With Atrial Fibrillation:A Systematic Review and Meta-analysis[J].Clinical Cardiology,2015,38(9):555-561. [11]Steensig K,Olesen K,Thim T,et al.Predicting stroke in patients without atrial fibrillation[J].Eur J Clin Invest,2019:e13103. [12]Szymanski FM,Lip GYH,Filipiak KJ,et al.Stroke Risk Factors Beyond the CHA 2 DS 2 -VASc Score:Can We Improve Our Identification of"High Stroke Risk"Patients With Atrial Fibrillation[J].American Journal of Cardiology,2015,116(11):1781-1788. [13]Fox KAA.Dual or single antiplatelet therapy with anticoagulation[J].Lancet,2013,381(9872):1080-1081. [14]Badjatiya A,Rao SV.Advances in Antiplatelet and Anticoagulant Therapies for NSTE-ACS[J].Curr Cardiol Rep,2019,21(1):3. [15]Jacobs MS,Tieleman RG.Optimal antithrombotic treatment of patients with atrial fibrillation undergoing percutaneous coronary intervention: triple therapy is too much[J].Netherlands Heart Journal,2018,26(6):334-340. [16]Gibson CM,Mehran R,Bode C,et al.Prevention of Bleeding in Patients with Atrial Fibrillation Undergoing PCI[J].New England Journal of Medicine,2016,375(25):2423. [17]Mantis C,Alexopoulos D.Antithrombotic treatment in atrial fibrillation patients undergoing PCI:Is dual therapy the winner[J].Thromb Res,2019(176):133-139. [18]Raco DL.After PCI in AF,dual antithrombotic therapy with dabigatran reduced bleeding compared with triple therapy[J].Ann Intern Med,2017,167(12):C70. [19]Lopes RD,Heizer G,Aronson R,et al.Antithrombotic Therapy after Acute Coronary Syndrome or PCI in Atrial Fibrillation[J].N Engl J Med,2019,380(16):1509-1524. [20]January CT,Wann LS,Calkins H,et al.2019 AHA/ACC/HRS Focused Update of the 2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation[J].Circulation,2019(1):R665. [21]黄从新,张澍,黄德嘉,等.心房颤动:目前的认识和治疗建议(2018)[J].中华心律失常学杂志,2018,22(4):279-346. [22]中华医学会心血管病学分会.非ST段抬高型急性冠状动脉综合征诊断和治疗指南(2016)[J].中华心血管病杂志,2017,45(5):359.

相似文献/References:

[1]姜亦瑶,王 凯,施 超.心肌纤维化引发心房颤动的研究进展[J].医学信息,2018,31(12):28.[doi:10.3969/j.issn.1006-1959.2018.12.010]
　JIANG Yi-yao,WANG Kai,SHI Chao.Research Progress of Atrial Fibrillation Caused by Myocardial Fibrosis[J].Journal of Medical Information,2018,31(14):28.[doi:10.3969/j.issn.1006-1959.2018.12.010]
[2]张定欣,林先和.经食道三维超声在房颤二尖瓣结构变化对其 返流程度影响中的应用[J].医学信息,2018,31(12):76.[doi:10.3969/j.issn.1006-1959.2018.12.023]
　ZHANG Ding-xin,LIN Xian-he.Application of Transesophageal Three-dimensional Ultrasound in the Influence of Mitral Valve Structure Changes on the Degree of Reflux in Atrial Fibrillation[J].Journal of Medical Information,2018,31(14):76.[doi:10.3969/j.issn.1006-1959.2018.12.023]
[3]王淑娟,林祥灿.血浆NT-proBNP水平与同型半胱氨酸对 糖尿病合并心房颤动的相关性研究[J].医学信息,2018,31(14):169.[doi:10.3969/j.issn.1006-1959.2018.14.053]
　WANG Shu-juan,LIN Xiang-can.Correlation between Plasma NT-proBNP level and Homocysteine in Patients with Diabetes Mellitus Complicated with Atrial Fibrillation[J].Journal of Medical Information,2018,31(14):169.[doi:10.3969/j.issn.1006-1959.2018.14.053]
[4]陶春艳.柔性护理在胺碘酮治疗心房颤动护理中的应用研究[J].医学信息,2018,31(24):154.[doi:10.3969/j.issn.1006-1959.2018.24.046]
　TAO Chun-yan.Application of Flexible Nursing in the Treatment of Atrial Fibrillation with Amiodarone[J].Journal of Medical Information,2018,31(14):154.[doi:10.3969/j.issn.1006-1959.2018.24.046]
[5]赵殿儒,祁景蕊.不同剂量瑞舒伐他汀对急性冠脉综合征患者心功能和炎症因子的影响[J].医学信息,2019,32(01):148.[doi:10.3969/j.issn.1006-1959.2019.01.046]
　ZHAO Dian-ru,YAN Jing-rui.Effects of Different Doses of Rosuvastatin on Cardiac Function and Inflammatory Factors in Patients with Acute Coronary Syndrome[J].Journal of Medical Information,2019,32(14):148.[doi:10.3969/j.issn.1006-1959.2019.01.046]
[6]镡子鸣,叶怀阔,任长杰.超敏C反应蛋白及妊娠相关血浆蛋白A预测再发急性冠脉综合征的临床价值[J].医学信息,2019,32(08):173.[doi:10.3969/j.issn.1006-1959.2019.08.055]
　TAN Zi-ming,YE Huai-kuo,et al.Clinical Value of High-sensitivity C-reactive Protein and Pregnancy-associated Plasma Protein A in Predicting Recurrent Acute Coronary Syndrome[J].Journal of Medical Information,2019,32(14):173.[doi:10.3969/j.issn.1006-1959.2019.08.055]
[7]梁道博,姚卜飞,夏双燕.氯吡格雷联合阿司匹林治疗急性冠脉综合征疗效与 安全性的Meta分析[J].医学信息,2019,32(11):76.[doi:10.3969/j.issn.1006-1959.2019.11.021]
　LIANG Dao-bo,YAO Bu-fei,XIA Shuang-yan.Meta-analysis of the Efficacy and Safety of Clopidogrel Combined with Aspirin in the Treatment of Acute Coronary Syndrome[J].Journal of Medical Information,2019,32(14):76.[doi:10.3969/j.issn.1006-1959.2019.11.021]
[8]古俊楠,张牧秋,王建强,等.可穿戴设备在心房颤动诊治中的应用[J].医学信息,2019,32(15):34.[doi:10.3969/j.issn.1006-1959.2019.15.012]
　GU Jun-nan,ZHANG Mu-qiu,WANG Jian-qiang,et al.Application of Wearable Devices in the Diagnosis and Treatment of Atrial Fibrillation[J].Journal of Medical Information,2019,32(14):34.[doi:10.3969/j.issn.1006-1959.2019.15.012]
[9]刘 瑜,王建强,古俊楠,等.房颤合并功能性二尖瓣返流研究[J].医学信息,2019,32(15):51.[doi:10.3969/j.issn.1006-1959.2019.15.017]
　LIU Yu,WANG Jian-qiang,GU Jun-nan,et al.Study on Atrial Fibrillation Combined with Functional Mitral Regurgitation[J].Journal of Medical Information,2019,32(14):51.[doi:10.3969/j.issn.1006-1959.2019.15.017]
[10]朱文书,张理想,游杨杨,等.长链非编码RNA MIAT表达水平与心房颤动导管消融术后复发的关系[J].医学信息,2021,34(04):75.[doi:10.3969/j.issn.1006-1959.2021.04.020]
　ZHU Wen-shu,ZHANG Li-xiang,YOU Yang-yang,et al.Relationship Between the Expression Level of Long Non-coding RNA MIAT and Recurrence After Catheter Ablation of Atrial Fibrillation[J].Journal of Medical Information,2021,34(14):75.[doi:10.3969/j.issn.1006-1959.2021.04.020]
[11]张牧秋,古俊楠,刘 瑜,等.NOACS治疗房颤合并急性冠脉综合征的研究[J].医学信息,2019,32(13):28.[doi:10.3969/j.issn.1006-1959.2019.13.010]
　ZHANG Mu-qiu,GU Jun-nan,LIU Yu,et al.Study of NOACS in the Treatment of Atrial Fibrillation Complicated with Acute Coronary Syndrome[J].Journal of Medical Information,2019,32(14):28.[doi:10.3969/j.issn.1006-1959.2019.13.010]

更新日期/Last Update: 2019-07-15