The Ideal Anticoagulation Strategy in ST-Elevation Myocardial Infarction

被引：9

作者：

Chandrasekhar, Jaya ^{[1
]}

Mehran, Roxana ^{[1
,2
]}

机构：

[1] Icahn Sch Med Mt Sinai, New York, NY 10029 USA

[2] Cardiovasc Res Fdn, New York, NY USA

来源：

PROGRESS IN CARDIOVASCULAR DISEASES | 2015年 / 58卷 / 03期

关键词：

ST-elevation myocardial infarction; Anticoagulation; Unfractionated heparin; Low molecular weight heparin; Bivalirudin; Glycoprotein IIb/IIIa inhibitors; PERCUTANEOUS CORONARY INTERVENTION; MOLECULAR-WEIGHT HEPARIN; GP IIB/IIIA INHIBITORS; UNFRACTIONATED HEPARIN; INTRAVENOUS ENOXAPARIN; UNSELECTED PATIENTS; CLINICAL-OUTCOMES; RISK SCORE; BIVALIRUDIN; EFFICACY;

D O I：

10.1016/j.pcad.2015.08.007

中图分类号：

R5 [内科学];

学科分类号：

100201 [内科学];

摘要：

Heparin has been the principal anticoagulant in the management of ST-elevation myocardial infarction (STEMI) but has several limitations. Although glycoprotein IIb/IIIa inhibitors have been major adjuncts in previous years, in the era of novel P2Y(12) receptor inhibitors they may have a greater role in bailout. Low molecular weight heparins have been extensively studied in fibrinolysis trials but data in primary percutaneous coronary intervention (PCI) are scarce. The direct thrombin inhibitor bivalirudin overcomes several shortcomings of heparins and has demonstrated a significant reduction in bleeding outcomes and net adverse cardiac events at the cost of increased acute stent thrombosis. This review discusses the pharmacology and clinical trial evidence for different anticoagulant treatment options in STEMI with a proposed selection strategy in contemporary primary PCI. (C) 2015 Elsevier Inc. All rights reserved.

引用

页码：247 / 259

页数：13

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