冠状动脉支架植入后的医疗管理:一项审查
Emmanouil S Brilakis1, Vishal G Patel, Subhash Banerjee
1VA North Texas Health Care System and University of Texas Southwestern Medical Center at Dallas, Dallas, TX 75216, USA. emmanouil.brilakis@va.gov
JAMA
|July 11, 2013
概括
穿皮冠状动脉干预 (PCI) 后的最佳医疗包括用阿司匹林和P2Y12抑制剂进行12个月的双抗血小板治疗 (DAPT). 在接受PCI的患者中,DAPT对于减少支架血栓形成和心血管事件至关重要.
科学领域:
- 心脏病学 心脏病学
- 药理学 药理学是指药理学的学科.
- 干预心脏病学 干预心脏病学
背景情况:
- 使用支架的穿皮冠状动脉干预 (PCI) 是一种常见的重血管化程序.
- 优化PCI后的结果对于患者管理至关重要.
研究的目的:
- 审查目前关于PCI后最佳医疗治疗的文献.
- 为PCI后药物治疗提供基于证据的建议.
主要方法:
- 在PubMed和Cochrane图书馆 (2000-2013) 进行了全面的文献搜索.
- 包括随机对照试验,系统审查和元分析.
- 手动搜索的研究的文献资料.
主要成果:
- 使用阿司匹林和P2Y12抑制剂的双抗血小板治疗 (DAPT) 是标准的护理,减少支架血栓形成和心血管事件.
- 阿司匹林应该是无限期的;P2Y12抑制剂12个月,正在研究最佳持续时间.
- 新的P2Y12抑制剂 (prasugrel,ticagrelor) 在急性冠状动脉综合征中提供更大的缺血事件减少,但增加出血风险.
结论:
- 双抗血小板治疗仍然是PCI后医疗管理的基石.
- 药物治疗的进步继续改善高风险PCI患者的治疗结果.
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