Historical Evolution of the Anticoagulant-Antiplatelet Therapy in Patients with Mitral Valve Disease Associated to Atrial Fibrillation or Mechanical Valve Prosthesis. Role of Omeprazole

In this review article we analyze the historical evolution of anticoagulant and antiplatelet therapies in the treatment of atrial fibrillation plus complicated heart diseases. Its combined use, compared with anticoagulation alone, has been widely used to significantly reduce thromboembolic risk. Major bleeding risk has been usually registered during combined antithrombotic therapy, which is mainly due to gastric bleeding, but enteric coating antiplatelet tablets can effectively protect against gastric mucosal damage, and the addition of proton-pump inhibitors (omeprazole) can avoid it.

非ST段抬高急性冠状动脉综合征诊疗策略新进展

随着对非ST段抬高急性冠状动脉综合征病理生理机制理解的不断深入,使其治疗方式不断得到提高,临床预后不断得到改善。低分子肝素、血小板膜糖蛋白Ⅱb/Ⅲa受体拮抗剂及早期再血管化治疗对高危的患者均显示出强大的临床益处,而氯吡格雷的益处似乎覆盖了所有的低、中、高危患者,直接凝血酶抑制剂的作用值得进一步探讨。危险分层策略是作出治疗决定的基础,为新治疗的选择提供了依据。