合并心房颤动患者经导管主动脉置换术后抗血栓治疗的研究进展

Research Progress of Antithrombotic Therapy after Transcatheter Aortic Replacement in Patients with Atrial Fibrillation

接受经导管主动脉瓣置换术(TAVR)治疗的严重主动脉瓣狭窄(AS)患者中超过1/3合并心房颤动(AF),此类人群发生血栓栓塞、出血和死亡事件的风险显著增加。目前对于无长期口服抗凝适应证的TAVR患者,建议首选单抗血小板治疗,而关于合并AF的TAVR患者最佳的抗血栓治疗选择尚不完全明确。文章基于最新的指南共识和临床研究数据,对合并AF的TAVR患者最佳抗血栓策略的制定进行综述。

Atrial fibrillation(AF)is present in more than one third of patients with severe aortic stenosis(AS)undergoing transcatheter aortic valve replacement(TAVR),and the risk of thromboembolism,bleeding,and death is significantly increased in this population.Monoclonal antibody platelet therapy is currently recommended as the first choice for TAVR patients without long-term indications for oral anticoagulation.However,the optimal antithrombotic treatment options for TAVR patients with AF are not fully defined.This article reviews the development of optimal antithrombotic strategies for TAVR patients with AF based on the latest guideline consensus and clinical study data.