経皮冠動脈および構造的介入における直接口服抗凝固剤の管理
Johanna Jones1, Benjamin Waters2, Paul Wright2
1Centre for Cardiovascular Medicine and Devices, William Harvey Research Institute, Queen Mary University of London, London, United Kingdom.
Kardiologia polska
|February 13, 2026
まとめ
経皮冠動脈介入の場合は,直接経口抗凝固剤 (DOAC) を継続することは安全です. しかし,構造的介入では,より高い出血リスクのため,DOACの中断が推奨されます. 合わせたアプローチが推奨されます.
科学分野:
- 心臓病学 心臓病学
- 薬理学 薬理学とは
背景:
- 経皮冠動脈干渉 (PCI) 中の直接経口抗凝固剤 (DOAC) の管理は,臨床的な課題を提示しています.
- 現在の周辺手続き管理戦略は変動し,確固たる証拠がない.
研究 の 目的:
- DOACの薬理動力学,ガイドラインの勧告,中断対継続戦略の証拠をレビューする.
- 心臓の介入中にDOACsの患者および手順特有の管理を伝えるために.
主な方法:
- DOACsの薬理 Literature review of pharmacokinetic properties of DOACs. DOACs. DOACs. DOACs. DOACs. DOACs. DOACs. DOACs. DOACs. DOACs. DOACs. DOACs. DOACs. DOACs. DOACs.
- DOAC管理のための現在のガイドラインの勧告の評価.
- 冠動脈および構造的介入におけるDOAC戦略に関する観察および見通しの研究の分析.
主要な成果:
- 放射性アクセスPCIにおける不中断のDOAC治療は,低出血および血栓塞栓性イベントと関連しています.
- トランスキャセター構造介入におけるDOACの継続は,高出血リスクによる最近のデータによって支持されていません.
- アクセスサイト,手順の複雑さ,腎機能を考慮して,患者および手順特有のアプローチが提案されています.
結論:
- 低リスクのPCI患者では,通常の処置前のDOAC中断は不要である可能性があります.
- DOACの管理は,統一された中断プロトコルから離れて,個別化されるべきです.
- 特定の患者集団における周術DOAC管理については,さらなる予期的なランダム化試験が必要である.
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