《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

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”

2020年11月,美国心脏病学会(ACC)发布《2020 ACC ECDP: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》,对需要同时使用抗凝(AC)和抗血小板(APT)患者提供一个决策框架。专家共识决策路径(ECDPs)针对4种临床情况提出抗栓建议,分别是接受口服抗凝药(OAC)治疗的心房颤动(AF)患者需要经皮冠状动脉介入治疗(PCI)和抗血小板治疗(APT)、接受APT治疗的动脉粥样硬化性心脏病(ASCVD)的患者新发AF需要OAC治疗、既往静脉血栓栓塞(VTE)接受AC治疗的患者需要PCI和APT以及接受APT治疗的ASCVD患者新发VTE需要AC治疗。该文对该路径进行全面解读,包括多个路径图和用药表格,以期为临床治疗提供参考。

In November 2020,the American College of Cardiology(ACC) published "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",which provides a framework for decision-making among patients who require concomitant use of an anticoagulant(AC) and antiplatelet therapy(APT).Expert consensus decision pathway(ECDP) made antithrombotic recommendations for four clinical situations: a patient with atrial fibrillation(AF) receiving an OAC who now needs percutaneous coronary intervention(PCI) and APT,a patient on APT for ASCVD with new-onset AF requiring an OAC,a patient with prior venous thromboembolism(VTE) receiving an AC who now needs PCI and APT,a patient on APT for ASCVD with a new VTE requiring an ACP.This paper has made a comprehensive interpretation of this path, including a number of path maps and medication forms, in order to provide reference for clinical treatment.