经皮冠状动脉介入治疗术后接受非心脏外科手术患者的抗血小板药物治疗
陈艳,袁晋青
摘要(Abstract):
<正>越来越多患者在冠状动脉支架术后面临非心脏外科手术治疗,在围术期缺血和出血并发症的风险都显著增高。有文献报道,经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)术后2年内,5%~15%患者面临非心脏外科手术治疗[1]。手术所引起的高凝和炎症内环境、围术期停用抗血小板药物以及早期支架置入部位内皮化不全等原因,均易造成非心脏外科围术期缺血风险增高。相关研究表明,
关键词(KeyWords): 经皮冠状动脉介入治疗;非心脏外科手术;抗血小板药物治疗
基金项目(Foundation): 国家自然科学基金(81470486)
作者(Author): 陈艳,袁晋青
参考文献(References):
- [1]Capodanno D,Angiolillo DJ.Management of antiplatelet therapy in patients with coronary artery disease requiring cardiac and noncardiac surgery.Circulation,2013,128(25):2785-2798.
- [2]Douketis JD,Spyropoulos AC,Spencer FA,et al.Perioperative management of antithrombotic therapy:Antithrombotic Therapy and Prevention of Thrombosis,9th ed:American College of Chest Physicians Evidence-Based Clinical Practice Guidelines.Chest,2012,141(2 Suppl):e326S-e350S.
- [3]Rossini R,Capodanno D,Lettieri C,et al.Prevalence,predictors,and long-term prognosis of premature discontinuation of oral antiplatelet therapy after drug eluting stent implantation.Am J Cardiol,2011,107(2):186-194.
- [4]崔炜.解读最新证据:再议双联抗血小板治疗持续时间问题.中国介入心脏病学杂志,2015,23(3):173-176.
- [5]Windecker S,Kolh P,Alfonso F,et al.2014 ESC/EACTS Guidelines on myocardial revascularization:The Task Force on Myocardial Revascularization of the European Society of Cardiology(ESC)and the European Association for CardioThoracic Surgery(EACTS)Developed with the special contribution of the European Association of Percutaneous Cardiovascular Interventions(EAPCI).Eur Heart J,2014,35(37):2541-2619.
- [6]O'Gara PT,Kushner FG,Ascheim DD,et al.2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction:a report of the American College of Cardiology Foundation/American Heart Association Task Force on practice guidelines.J Am Coll Cardiol,2013,61(4):e78-e140.
- [7]Amsterdam EA,Wenger NK,Brindis RG,et al.2014 AHA/ACC Guideline for the management of patients with non-STelevation acute coronary syndromes:a report of the American College of Cardiology/American Heart Association Task Force on practice guidelines.J Am Coll Cardiol,2014,64(24):e139-e228.
- [8]Roffi M,Patrono C,Collet JP,et al.2015 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation:Task Force for the Management of Acute Coronary Syndromes in Patients Presenting without Persistent ST-Segment Elevation of the European Society of Cardiology(ESC).Eur Heart J,2016,37(3):267-315.
- [9]Collet JP,Montalescot G,Blanchet B,et al.Impact of prior use or recent withdrawal of oral antiplatelet agents on acute coronary syndromes.Circulation,2004,110(16):2361-2367.
- [10]Burger W,Chemnitius JM,Kneissl GD,et al.Low-dose aspirin for secondary cardiovascular prevention cardiovascular risks after its perioperative withdrawal versus bleeding risks with its continuation:review and meta-analysis.J Intern Med,2005,257(5):399-414.
- [11]Oscarsson A,Gupta A,Fredrikson M,et al.To continue or discontinue aspirin in the perioperative period:a randomized,controlled clinical trial.Br J Anaesth,2010,104(3):305-312.
- [12]Mantz J,Samama CM,Tubach F,et al.Impact of preoperative maintenance or interruption of aspirin on thrombotic and bleeding events after elective non-cardiac surgery:the multicentre,randomized,blinded,placebo-controlled,STRATAGEM trial.Br J Anaesth,2011,107(6):899-910.
- [13]Prevention of pulmonary embolism and deep vein thrombosis with low dose aspirin:Pulmonary Embolism Prevention(PEP)trial.Lancet,2000,355(9212):1295-1302.
- [14]Chassot PG,Delabays A,Spahn DR.Perioperative antiplatelet therapy:the case for continuing therapy in patients at risk of myocardial infarction.Br J Anaesth,2007,99(3):316-328.
- [15]Devereaux PJ,Mrkobrada M,Sessler DI,et al.Aspirin in patients undergoing noncardiac surgery.N Engl J Med,2014,370(16):1494-1503.
- [16]Spertus JA,Kettelkamp R,Vance C,et al.Prevalence,predictors,and outcomes of premature discontinuation of thienopyridine therapy after drug-eluting stent placement:results from the PREMIER registry.Circulation,2006,113(24):2803-2809.
- [17]Ho PM,Peterson ED,Wang L,et al.Incidence of death and acute myocardial infarction associated with stopping clopidogrel after acute coronary syndrome.JAMA,2008,299(5):532-539.
- [18]Albaladejo P,Marret E,Samama CM,et al.Non-cardiac surgery in patients with coronary stents:the RECO study.Heart,2011,97(19):1566-1572.
- [19]Mehran R,Baber U,Steg PG,et al.Cessation of dual antiplatelet treatment and cardiac events after percutaneous coronary intervention(PARIS):2 year results from a prospective observational study.Lancet,2013,382(9906):1714-1722.
- [20]Eisenberg MJ,Richard PR,Libersan D,et al.Safety of shortterm discontinuation of antiplatelet therapy in patients with drugeluting stents.Circulation,2009,119(12):1634-1642.
- [21]van Kuijk JP,Flu WJ,Schouten O,et al.Timing of noncardiac surgery after coronary artery stenting with bare metal or drugeluting stents.Am J Cardiol,2009,104(9):1229-1234.
- [22]Feagins LA,Uddin FS,Davila RE,et al.The rate of postpolypectomy bleeding for patients on uninterrupted clopidogrel therapy during elective colonoscopy is acceptably low.Dig Dis Sci,2011,56(9):2631-2638.
- [23]Wilson SH,Fasseas P,Orford JL,et al.Clinical outcome of patients undergoing non-cardiac surgery in the two months following coronary stenting.J Am Coll Cardiol,2003,42(2):234-240.
- [24]Eberli D,Chassot PG,Sulser T,et al.Urological surgery and antiplatelet drugs after cardiac and cerebrovascular accidents.J Urol,2010,183(6):2128-2136.
- [25]Riddell JW,Chiche L,Plaud B,et al.Coronary stents and noncardiac surgery.Circulation,2007,116(16):e378-e382.
- [26]Mc Falls EO,Ward HB,Moritz TE,et al.Coronary-artery revascularization before elective major vascular surgery.N Engl J Med,2004,351(27):2795-2804.
- [27]Brilakis ES,Orford JL,Fasseas P,et al.Outcome of patients undergoing balloon angioplasty in the two months prior to noncardiac surgery.Am J Cardiol,2005,96(4):512-514.
- [28]Kang SH,Park KW,Kang DY,et al.Biodegradable-polymer drug-eluting stents vs.bare metal stents vs.durable-polymer drug-eluting stents:a systematic review and Bayesian approach network meta-analysis.Eur Heart J,2014,35(17):1147-1158.
- [29]Gwon HC,Hahn JY,Park KW,et al.Six-month versus 12-month dual antiplatelet therapy after implantation of drug-eluting stents The Efficacy of Xience/Promus Versus Cypher to Reduce Late Loss After Stenting(EXCELLENT)randomized,multicenter study.Circulation,2012,125(3):505-513.
- [30]Kim BK,Hong MK,Shin DH,et al.A new strategy for discontinuation of dual antiplatelet therapy:the RESET Trial(REal Safety and Efficacy of 3-month dual antiplatelet Therapy following Endeavor zotarolimus-eluting stent implantation).J Am Coll Cardiol,2012,60(15):1340-1348.
- [31]Abbott.Abbott's XIENCE PRIMETMand XIENCE Vdrug eluting stents receive indication in Europe for minimum 3-month duration of dual anti-platelet therapy.[EB/OL][2012-5-15].http://www.ptca.org/news/2012/0515_XIENCE.html.
- [32]Burt Cohen.Medtronic stent gets CE mark label update for one month of DAPT.[2013-3-4].http://www.ptca.org/news/2013/0304_MEDTRONIC_RESOLUTE.html.
- [33]Schouten O,van Domburg RT,Bax JJ,et al.Noncardiac surgery after coronary stenting:early surgery and interruption of antiplatelet therapy are associated with an increase in major adverse cardiac events.J Am Coll Cardiol,2007,49(1):122-124.
- [34]Cruden NL,Harding SA,Flapan AD,et al.Previous coronary stent implantation and cardiac events in patients undergoing noncardiac surgery.Circ Cardiovasc Interv,2010,3(3):236-242.
- [35]Holcomb CN,Graham LA,Richman JS,et al.The incremental risk of noncardiac surgery on adverse cardiac events following coronary stenting.J Am Coll Cardiol,2014,64(25):2730-2739.
- [36]Fleisher LA,Fleischmann KE,Auerbach AD,et al.2014 ACC/AHA guideline on perioperative cardiovascular evaluation and management of patients undergoing noncardiac surgery:a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines.Developed in collaboration with the American College of Surgeons,American Society of Anesthesiologists,American Society of Echocardiography,American Society of Nuclear Cardiology,Heart Rhythm Society,Society for Cardiovascular Angiography and Interventions,Society of Cardiovascular Anesthesiologists,and Society of Vascular Medicine Endorsed by the Society of Hospital Medicine.J Nucl Cardiol,2015,22(1):162-215.
- [37]Kristensen SD,Knuuti J,Saraste A,et al.2014 ESC/ESA Guidelines on non-cardiac surgery:cardiovascular assessment and management:The Joint Task Force on non-cardiac surgery:cardiovascular assessment and management of the European Society of Cardiology(ESC)and the European Society of Anaesthesiology(ESA).Eur Heart J,2014,35(35):2383-2431.
- [38]Alshawabkeh LI,Prasad A,Lenkovsky F,et al.Outcomes of a preoperative"bridging"strategy with glycoproteinⅡb/Ⅲa inhibitors to prevent perioperative stent thrombosis in patients with drug-eluting stents who undergo surgery necessitating interruption of thienopyridine administration.Euro Intervention,2013,9(2):204-211.
- [39]Angiolillo DJ,Firstenberg MS,Price MJ,et al.Bridging antiplatelet therapy with cangrelor in patients undergoing cardiac surgery:a randomized controlled trial.JAMA,2012,307(3):265-274.