关注急性冠脉综合征合并慢性肾脏病及其抗栓治疗策略

Focus on acute coronary syndrome in patients with chronic kidney disease and antithrombotic treatment strategy

慢性肾脏病(CKD)是心血管发病率、死亡率以及全因死亡率的独立预测因素。急性冠状动脉综合征(ACS)合并CKD较为常见,这一人群往往预后更差,死亡和出血风险更高。抗栓治疗是ACS患者的基本治疗措施,如何平衡ACS合并CKD患者的缺血和出血风险十分重要。本文结合近年临床试验研究结果和相关指南,从ACS合并CKD患者的流行病学、预后、临床表现及其抗栓药物治疗策略等方面进行阐述,旨在进一步降低不良事件风险并实现最大获益。

Chronic kidney disease（CKD）is an independent predictor of cardiovascular morbidity,cardiovascular mortality and all-cause mortality.CKD is frequently encountered among patients presenting with acute coronary syndrome（ACS）,which means worse prognosis,higher risk of death and bleeding.Antithrombotic therapy is the cornerstone treatment in ACS patients.How to balance the ischemia and bleeding risk in ACS patients with CKD is an important issue.In this review,according to the recent clinical trials and guidelines,we will clarify the epidemiology,prognosis,clinical presentation and antithrombotic treatment strategy of the ACS patients with CKD,in order to provide the greatest benefit while reducing the risk of adverse events.