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Interventional Treatment for Structural Heart Disease最新文献

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Dual Antiplatelet Therapy after PCI: When Could We Go Shorter? PCI术后双重抗血小板治疗:何时可以缩短疗程?
Pub Date : 2021-11-24 DOI: 10.5772/intechopen.96328
Marcel Santaló-Corcoy, G. Marquis-Gravel, J. Tanguay
The optimal duration of dual antiplatelet therapy (DAPT) after percutaneous coronary intervention (PCI) remains an important clinical question in interventional cardiology. Several clinical and angiographic variables are associated with an increased risk for thrombotic events, and prolonged DAPT duration may improve long term clinical outcome. However, some patients also present high bleeding risk (HBR) characteristics and may require a shorter DAPT duration. The guidelines recommendations consider the data from randomized clinical trials, however numerous exclusion criteria may create gaps in the evidence leading to uncertainties, the need for expert opinion and patient level decision making. Furthermore, the stent platforms have evolved in such way that opportunities now exist to shorten duration of DAPT. This chapter will review the variables associated with ischemic and bleeding risks as well as different stent platforms to help clinicians optimize DAPT duration in patients undergoing PCI.
经皮冠状动脉介入治疗(PCI)后双重抗血小板治疗(DAPT)的最佳持续时间一直是介入心脏病学中的一个重要临床问题。几个临床和血管造影变量与血栓形成事件的风险增加有关,延长DAPT持续时间可能改善长期临床结果。然而,一些患者也表现出高出血风险(HBR)特征,可能需要更短的DAPT持续时间。指南建议考虑随机临床试验的数据,然而众多的排除标准可能会在证据中造成空白,导致不确定性,需要专家意见和患者层面的决策。此外,支架平台的发展使得缩短DAPT持续时间成为可能。本章将回顾与缺血和出血风险相关的变量以及不同的支架平台,以帮助临床医生优化PCI患者的DAPT持续时间。
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Interventional Treatment for Structural Heart Disease
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