急性冠脉综合征合并慢性肾功能不全抗栓药物治疗进展

Advances in antithrombotic therapy in acute coronary syndrome patients with chronic renal insufficiency

急性冠脉综合征(ACS)是严重威胁人类健康的重大疾病。慢性肾功能不全(CKD)已经成为ACS的高危因素,并且与不良心血管事件预后高度相关。抗血小板治疗对于ACS患者的早期以及远期预后至关重要,但是由于大多数药物经肾脏代谢,更重要的是CKD即存在出血倾向,同时又有高凝状态,因此更加合理的抗栓治疗对这类患者更为重要。由于大多数关于ACS抗血小板药物的大型临床研究将其作为排除标准,进而使得可用于指导CKD并发ACS患者抗血小板治疗的循证医学证据有限,为该类患者的治疗和管理带来临床的困惑。基于此,本文将近期的ACS并发CKD患者抗栓治疗临床研究进展作一综述。

Acute coronary syndrome （ACS） is a threatening disease and even worse when chronic kidney disease （CKD） is prevalent, which affects an ever-increasing proportion of ACS patients and is closely associated with major adverse cardiovascular events. Dual antiplatelet therapy is very important for early and long-term prognosis in ACS patients. As most drugs are eliminated by kidneys and patients with chronic renal insufficiency often have bleeding tendency drugs is patients limited. and hypercoagulability states, proper use of antithrombotic significantly important for these patients. Most large randozmized controlled trials exclude those with CKD, making medical evidence for this subpopulation needing This manuscript reviews studies concerning antithrombotic theranv for ACS antiplatelet therapy CKD with ACS.