Dual antiplatelet therapy of aspirin and a thienopyridine is the standard of care following coronary stenting. Patients who are on chronic warfarin therapy and receive a coronary stent need to be treated with the triple therapy of aspirin, clopidogrel and warfarin; however, the bleeding risk in these patients is unknown. To evaluate the bleeding risk in patients requiring chronic warfarin therapy and undergoing stent implantation, we compared 107 consecutive patients on chronic warfarin therapy who underwent coronary stenting and were discharged on aspirin, clopidogrel and warfarin to 107 contemporary patients who were treated with aspirin and clopidogrel. We evaluated their bleeding history before and after coronary stenting. Major bleeding was defined as bleeding that was significantly disabling, intraocular or requiring at least 2 units of blood transfusion. Minor bleeding was defined as other bleeding that led to interruption of the medications. Patients on triple therapy were younger and more likely to have hypertension. This group had significantly higher major bleeding (6.6% vs. 0%; p = 0.03) and minor bleeding (14.9% vs. 3.8%; p = 0.01) compared with the dual antiplatelet therapy group. In the triple therapy group, the international normalized ratio or aspirin dosage did not influence the bleeding risk. In patients requiring warfarin therapy, the addition of dual antiplatelet therapy is associated with an approximately 7% major bleeding risk. Thus, novel regimens are needed to reduce the bleeding risk.

译文

阿司匹林和噻吩吡啶的双重抗血小板治疗是冠状动脉支架术后的标准治疗。接受慢性华法林治疗并接受冠状动脉支架的患者需要接受阿司匹林,氯吡格雷和华法林的三联疗法治疗; 但是,这些患者的出血风险尚不清楚。为了评估需要慢性华法林治疗并接受支架植入的患者的出血风险,我们将107连续接受慢性华法林治疗并接受阿司匹林,氯吡格雷和华法林治疗的患者与接受阿司匹林和氯吡格雷治疗的107当代患者进行了比较。我们评估了冠状动脉支架置入前后的出血史。大出血定义为明显致残、眼内出血或需要至少2单位输血的出血。轻微出血被定义为导致药物中断的其他出血。接受三联疗法的患者更年轻,更有可能患有高血压。与双重抗血小板治疗组相比,该组的主要出血 (6.6% vs. 0%; p = 0.03) 和次要出血 (14.9% vs. 3.8%; p = 0.01) 明显更高。在三联疗法组中,国际标准化比率或阿司匹林剂量不影响出血风险。在需要华法林治疗的患者中,双重抗血小板治疗的增加与大约7% 的主要出血风险相关。因此,需要新的治疗方案来降低出血风险。

+1
+2
100研值 100研值 ¥99课程
检索文献一次
下载文献一次

去下载>

成功解锁2个技能,为你点赞

《SCI写作十大必备语法》
解决你的SCI语法难题!

技能熟练度+1

视频课《玩转文献检索》
让你成为检索达人!

恭喜完成新手挑战

手机微信扫一扫,添加好友领取

免费领《Endnote文献管理工具+教程》

微信扫码, 免费领取

手机登录

获取验证码
登录