心房颤动合并急性冠脉综合征的抗栓策略

Antithrombotic strategies for atrial fibrillation combined with acute coronary syndrome

心房颤动(简称房颤)是临床上最常见的持续性心律失常,抗凝治疗是预防房颤血栓并发症的基石。急性冠脉综合征是全球导致死亡的主要疾病之一,一般情况下双联抗血小板是治疗和预防该疾病的主要措施之一。然而当2种疾病同时存在时,同时进行抗凝和双联抗血小板,即三联抗栓治疗,会增加出血风险。因此,如何选择合适的抗栓治疗策略一直是临床实践中关注的热点。文章将结合临床试验、国内外指南及专家共识,对房颤合并急性冠脉综合征的抗栓策略作一阐述。

Atrial fibrillation(AF)is the most common sustained arrhythmia in clinical practice.Anticoagulation is the cornerstone treatment for preventing the thromboembolic complications of AF.Antiplatelet therapy is crucial for prevention and treatment of acute coronary syndrome(ACS),which is one of the leading causes of death globally.However,if the AF patients are with ACS,combining anticoagulntion with antiplatelet therapy(triple antithrombotic therapy)may increase the risk of bleeding.The selection of appropriate antithrombotic strategy has always been the focus of clinical practice.In this paper,we will summarize the antithrombotic strategies in managing AF combined with ACS based on clinical trials,guidelines,and expert consensus.