Intervención coronaria percutánea y anticoagulantes orales

Q4 Medicine
Juan M. Ruiz-Nodar , Fernando Torres Mezcúa , Cristina Cambra Poveda
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引用次数: 0

Abstract

Patients on long-term oral anticoagulation therapy who are scheduled to undergo a percutaneous coronary intervention are a high-risk population with a large number of comorbid conditions. This is a growing population that has a complicated prognosis because ischemic and bleeding events can occur over the short, medium and long term. Antithrombotic therapy, without doubt a key consideration in these patients, could have a substantial impact on prognosis. Maintenance therapy with oral anticoagulants is also a priority. Over the last few years, several antithrombotic regimens have been investigated with the principle aim of reducing hemorrhagic events while maintaining efficacy. To this end, studies have focused on: (i) shortening the duration of the dual antiplatelet therapy added to anticoagulation; and (ii) the use of antiplatelet monotherapy, particularly clopidogrel, along with an oral anticoagulant. Recently, the emergence of direct oral anticoagulants has generated great hope and excitement. These new drugs, which have a better safety profile than dicoumarinic anticoagulants, could produce substantial prognostic improvements in this context. The results of three clinical trials of direct oral anticoagulants in these highly complex patients are currently available. Their findings, together with another trial that is now in the follow-up phase, have the potential to substantially modify our usual clinical practice in coming years.

Supplement information: this article is part of a supplement entitled “Treatment of patients with atrial fibrillation undergoing percutaneous coronary intervention: an update”, which is sponsored by Boehringer Ingelheim.

经皮冠状动脉介入治疗和口服抗凝剂
长期口服抗凝治疗的患者计划接受经皮冠状动脉介入治疗,这是一个高风险人群,有大量的合并症。这是一个不断增长的人群,其预后复杂,因为缺血和出血事件可能在短期、中期和长期发生。抗血栓治疗,毫无疑问是这些患者的关键考虑因素,可能对预后有重大影响。口服抗凝剂的维持治疗也是优先考虑的。在过去的几年中,研究了几种抗血栓治疗方案,其主要目的是在保持疗效的同时减少出血事件。为此,研究主要集中在:(1)缩短抗凝治疗中加入的双重抗血小板治疗的持续时间;(ii)抗血小板单药治疗,特别是氯吡格雷与口服抗凝剂联合使用。最近,直接口服抗凝剂的出现产生了巨大的希望和兴奋。这些新药比双香豆素抗凝剂具有更好的安全性,可以在这种情况下显著改善预后。目前有三项直接口服抗凝剂治疗这些高度复杂患者的临床试验的结果。他们的发现,连同另一项目前处于随访阶段的试验,有可能在未来几年实质性地改变我们通常的临床实践。补充信息:本文是由勃林格殷格翰公司赞助的题为“经皮冠状动脉介入治疗心房颤动患者:最新进展”的补充文章的一部分。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Revista Espanola de Cardiologia Suplementos
Revista Espanola de Cardiologia Suplementos Medicine-Cardiology and Cardiovascular Medicine
CiteScore
1.20
自引率
0.00%
发文量
1
期刊介绍: Revista Española de Cardiología, is an international scientific journal dealing with cardiovascular medicine. Revista Española de Cardiología, the official publication of the Spanish Society of Cardiology, publishes research articles related to cardiovascular diseases. Articles are published in Spanish for the paper edition and in both Spanish and English in the electronic edition, which is available on the Internet. Regular sections include original articles reporting clinical or basic research, brief reports, review articles, editorials and letters to the Editor.
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