口服抗凝药在高缺血风险ST段抬高型心肌梗死治疗中的应用展望

Applicating of oral anticoagulants for stemi patients with high-risk ischemia

经皮冠状动脉介入(PCI)技术的开展极大地降低了ST段抬高型心肌梗死(STEMI)患者的死亡率。尽管口服抗凝药(OACs)在合并房颤的STEMI患者中的应用已经得到了广泛的认可,而对于存在前壁心肌梗死、室壁瘤形成、左室血栓形成、严重的室壁运动障碍等其他相关高缺血风险的STEMI患者是否应预防性地联用OACs在临床上目前尚有争议。本文汇总相关文献,对上述问题进行综述,以期为临床提供参考。

Percutaneous coronary intervention(PCI)technology has greatly reduce the mortality rate of patients with ST elevation myocardial infarction(STEMI).Although oral anticoagulants(OACs)have been widely recognized in STEMI patients with atrial fibrillation,it is still controversial whether prophylactic combination of oacs should be used in STEMI patients with high risk of ischemia such as anterior myocardial infarction,aneurysm formation,left ventricular thrombosis,severe wall mo⁃tion disorders,etc.This paper summarizes the relevant literature and summarizes the above problems in order to provide refer⁃ence for clinical practice.