《2020 ACC专家共识决策路径:合并心房颤动或静脉血栓栓塞的动脉粥样硬化性心血管疾病患者或接受经皮冠脉介入治疗患者抗凝和抗血小板治疗》解读*

尹琪楠,韩丽珠,边原,陈璐,黄雪飞,雷洋,宋玉洁,童荣生

Interpretation of “2020 ACC Expert Consensus Decision Pathway for Anticoagulant and Antiplatelet Therapy in Patients With Atrial Fibrillation or Venous Thromboembolism Undergoing Percutaneous Coronary Intervention or with Atherosclerotic Cardiovascular Disease”

Qinan YIN,Lizhu HAN,Yuan BIAN,Lu CHEN,Xuefei HUANG,Yang LEI,Yujie SONG,Rongsheng TONG

图3 接受AC治疗的患者PCI围手术期抗栓药物管理 1.择期PCI阿司匹林每日325 mgx1; 2.如果血栓风险高,出血风险小,可继续使用阿司匹林81 mg?d-1(作为三联疗法的一部分)最多30 d; 3.等待紧急PCI治疗的NSTE-ACS而不再使用抗凝治疗的患者,应在到达导管室之前开始静脉UFH。

Fig.3 PCI perioperative management of antithrombotic therapy in patients receiving AC 1.ASA 325 mg×1 for elective PCI; ASA 162-324 mg×1 for urgent/emergent PCI;2.If thrombotic risk is high and bleeding risk is low,can continue ASA 81 mg daily (as part of triple therapy) for up to 30 days;3.IV UFH should be initiated prior to catch lab arrival for those awaiting urgent PCI for an NSTE-ACS while no longer on therapeutic anticoagulation.