Anticoagulation in coronary intervention

作者: Uwe Zeymer , Sunil V. Rao , Gilles Montalescot

DOI: 10.1093/EURHEARTJ/EHW061

关键词: BivalirudinMedicineConventional PCIInternal medicineCoronary artery diseaseMyocardial infarctionHeparinCardiologyPercutaneous coronary interventionDirect thrombin inhibitorRandomized controlled trial

摘要: Percutaneous coronary intervention (PCI) induces thrombin generation and is associated with the risk of acute, subacute, or long-term ischaemic events. Therefore, intravenous anticoagulation recommended to minimize thrombotic complications. The intensity duration needed are dependent on clinical presentation (elective PCI for stable artery disease, non-ST elevation acute syndromes, primary ST-segment myocardial infarction) procedural features. As both periprocedural bleeding complications mortality, optimal level best agents a matter debate. Despite number limitations lack large randomized trials, unfractionated heparin (UFH) still been used in majority interventions. Intravenous enoxaparin, low-molecular-weight heparin, leads more predictable has compared UFH patients elective favourable results. direct inhibitor bivalirudin studied numerous trials consistently shown reduce when without glycoprotein IIb/IIIa inhibitors. This review will summarize current status results most recent give recommendations different scenarios.

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