Carlos Minguito Carazo , Tomás Benito-González , Armando Pérez de Prado , Felipe Fernández-Vázquez
{"title":"心房颤动患者的冠状动脉干预","authors":"Carlos Minguito Carazo , Tomás Benito-González , Armando Pérez de Prado , Felipe Fernández-Vázquez","doi":"10.1016/S1131-3587(19)30030-5","DOIUrl":null,"url":null,"abstract":"<div><p>Patients with atrial fibrillation and coronary artery disease often have an elevated risk of both ischemia and bleeding. In the context of oral anticoagulation, clopidogrel is the P2Y<sub>12</sub> inhibitor with the best safety profile. However, although it is recommended for patients with acute coronary syndromes, there is still some debate today about whether it should be used for pretreatment before invasive procedures. In patients scheduled to undergo an elective percutaneous coronary intervention, heparin bridging before the procedure is not recommended because this approach has been associated with an increased incidence of adverse events. Radial access should be preferred in the majority of cases when hemodynamics and the coronary anatomy permit. Although the evidence is still limited, it is recommended that low-dose unfractionated heparin should be administered during the procedure.</p><p>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.</p></div>","PeriodicalId":34926,"journal":{"name":"Revista Espanola de Cardiologia Suplementos","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Intervención coronaria en pacientes con fibrilación auricular\",\"authors\":\"Carlos Minguito Carazo , Tomás Benito-González , Armando Pérez de Prado , Felipe Fernández-Vázquez\",\"doi\":\"10.1016/S1131-3587(19)30030-5\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><p>Patients with atrial fibrillation and coronary artery disease often have an elevated risk of both ischemia and bleeding. In the context of oral anticoagulation, clopidogrel is the P2Y<sub>12</sub> inhibitor with the best safety profile. However, although it is recommended for patients with acute coronary syndromes, there is still some debate today about whether it should be used for pretreatment before invasive procedures. In patients scheduled to undergo an elective percutaneous coronary intervention, heparin bridging before the procedure is not recommended because this approach has been associated with an increased incidence of adverse events. Radial access should be preferred in the majority of cases when hemodynamics and the coronary anatomy permit. Although the evidence is still limited, it is recommended that low-dose unfractionated heparin should be administered during the procedure.</p><p>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.</p></div>\",\"PeriodicalId\":34926,\"journal\":{\"name\":\"Revista Espanola de Cardiologia Suplementos\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2019-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Revista Espanola de Cardiologia Suplementos\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S1131358719300305\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Revista Espanola de Cardiologia Suplementos","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1131358719300305","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"Medicine","Score":null,"Total":0}
Intervención coronaria en pacientes con fibrilación auricular
Patients with atrial fibrillation and coronary artery disease often have an elevated risk of both ischemia and bleeding. In the context of oral anticoagulation, clopidogrel is the P2Y12 inhibitor with the best safety profile. However, although it is recommended for patients with acute coronary syndromes, there is still some debate today about whether it should be used for pretreatment before invasive procedures. In patients scheduled to undergo an elective percutaneous coronary intervention, heparin bridging before the procedure is not recommended because this approach has been associated with an increased incidence of adverse events. Radial access should be preferred in the majority of cases when hemodynamics and the coronary anatomy permit. Although the evidence is still limited, it is recommended that low-dose unfractionated heparin should be administered during the procedure.
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.
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.