Management of antithrombotic therapy in patients with atrial fibrillation after percutaneous coronary intervention
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摘要: 对急性冠状动脉综合征(ACS)和(或)接受经皮冠状动脉介入治疗(PCI)的非瓣膜病心房颤动(NVAF)患者,确定最佳的抗血栓治疗方案是一个有争议的话题。已发表的随机对照试验(RCTs)显示,非维生素K拮抗剂口服抗凝药(NOAC)联合单一抗血小板治疗的双联抗栓方案有效,且出血风险较以维生素K拮抗剂(VKA)为基础的三联抗栓方案低。但上述研究存在一定的异质性,本文对上述研究的证据及相关异同点进行汇总,并结合国内外临床实践指南的更新,提供该研究领域的相关证据、最新进展、建议及未来方向。
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关键词:
- 心房颤动,非瓣膜病 /
- 急性冠状动脉综合征 /
- 经皮冠状动脉介入治疗 /
- 非维生素K拮抗剂口服抗凝药
Abstract: It is a controversial topic to determine the optimal antithrombotic strategy for patients with acute coronary syndrome(ACS) and/or non-valvular atrial fibrillation undergoing percutaneous coronary intervention(PCI). Published randomized controlled trials reported that dual antithrombotic treatments including non-vitamin K antagonist oral anticoagulant(NOAC) and single antiplatelet therapy is effective, and the risk of bleeding is lower than that of vitamin K antagonist(VKA)-based triple antithrombotic therapy. However, the above researches exist some heterogeneity. This manuscript summarizes the relevant evidence and differences, and provides the related evidence, latest progress, suggestions and future direction regarding of this field in combination with the update of guidelines. -
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