经皮冠状动脉介入治疗后短程双联抗血小板治疗的研究进展

Short-Term Dual Antiplatelet Therapy after Percutaneous Coronary Intervention

目前国内外指南大多数推荐经皮冠状动脉介入治疗(PCI)后采取标准双联抗血小板治疗(DAPT),以减少支架内血栓形成、预防缺血事件的发生。但长程DAPT方案势必会增加出血风险。新型药物洗脱支架使支架内血栓事件的发生率显著下降,新型P2Y12受体抑制剂具有更强的抗血小板作用以及PCI术中腔内影像学的应用,都大大降低了PCI术后心血管不良事件的发生率。对此,国内外开展了许多大型临床研究,以探求PCI术后最佳DAPT疗程,进而改善患者的临床净获益。现依据最新的研究进展,对短程DAPT的循证医学证据进行综述。

Currently most national and international guidelines recommend standard dual antiplatelet therapy(DAPT)after percutaneous coronary intervention(PCI)to reduce in-stent thrombosis and prevent ischemic events.However,the long-term DAPT program inevitably increases the risk of bleeding.New-generation drug eluting stent significantly reduce the incidence of in-stent thrombosis,new P2Y12 receptor blockers have stronger antiplatelet effects,and the application of intravascular imaging techniques during PCI have greatly reduced the incidence of adverse cardiovascular events after PCI.Therefore,many large-scale clinical studies have been carried out at home and abroad to explore the optimal duration of DAPT,and to improve the net clinical benefit of patients.This article will review the evidence of evidence-based medicine of short-term DAPT based on the latest research progress.