Ⅹa因子抑制剂治疗急性冠状动脉综合征的研究进展

Research of the factor-Ⅹ a inhibitors in the treatment of acute coronary syndrome

急性冠状动脉综合征（ACS）包括不稳定心绞痛、非ST段抬高型心肌梗死（NSTEMI）和ST段抬高型心肌梗死（STEMI）。虽然抗血小板药物已广泛用于ACS的治疗,但仍有部分ACS患者在发病的最初30d内发生再发心肌缺血或死亡〔1〕。故现已加强了对新型抗凝药物例如Ⅹa因子抑制剂、

Among patients with acute coronary syndrome,aggressive antiplatelet therapy with aspirin and thienopyridine reduces both short and long-term adverse cardiovascular events.There remains,however,an unacceptably high rate of residual recurrent ischemic events among such patients.It is reasonable to consider antithrombotic therapy is effective as coronary thrombosis is known to be composed of both platelets and fibrin.Long-term oral anticoagulation has been associated with a reduction of major adverse cardiovascular events after myocardial infarction,but the clinical use of warfarin and other coumarin derivatives has been hindered by an increased risk of hemorrhagic events.Large-scale trials have demonstrated the efficacy of novel procedural anticoagulants,such as selective factor-Xa inhibitors.The purpose of this review is to summarize the evidence for factor Xa inhibitors in later phases of clinical testing.