2023 年第 2 期 第 18 卷

新型口服抗凝药在心房颤动合并冠心病抗栓治疗中有效性及安全性的研究进展

Advance in the effectiveness and safety of new oral anticoagulants in the antithrombotic treatment of atrial fibrillation combined with coronary atherosclerotic heart disease

作者：覃润1陈璐2刘丽君1何艳3

英文作者：Qin Run1 Chen Lu2 Liu Lijun1 He Yan3

单位：1贵州医科大学，贵阳550000;2贵州医科大学附属医院药物临床实验中心，贵阳550000;3贵州医科大学附属医院心血管内科，贵阳550000

英文单位：1Guizhou Medical University Guiyang 550000 China; 2Drug Clinical Experiment Center the Affiliated Hospital of Guizhou Medical University Guiyang 550000 China; 3Department of Cardiovascular Medicine the Affiliated Hospital of Guizhou Medical University Guiyang 550000 China

关键词：心房颤动；冠心病（冠状动脉粥样硬化性心脏病）；经皮冠状动脉介入；新型口服抗凝药

英文关键词：Atrialfibrillation;Coronaryatheroscleroticheartdisease;Percutaneouscoronaryintervention;Noveloralanticoagulants

• 摘要：

• 心房颤动合并冠心病（冠状动脉粥样硬化性心脏病）抗栓治疗的选择一直是一个难题。在抗血小板的同时也需要抗凝治疗，选择抗栓治疗方案时，兼顾降低出血风险的同时又能取得最大的临床疗效是心房颤动合并冠心病抗栓治疗方案的关键。华法林作为心房颤动传统的抗凝药物，由于其自身的局限性，推动了新型口服抗凝药（NOAC）的兴起，在抗栓治疗中选择口服抗凝药有了新的选择和认识。然而NOAC在心房颤动合并冠心病患者中的临床疗效及安全性仍有一些争议。本文就NOAC应用于心房颤动合并冠心病患者抗栓治疗中的有效性及安全性作一综述。

• The choice of antithrombotic therapy for atrial fibrillation combined with coronary atherosclerotic heart disease has always been a difficult problem, and anticoagulation is required along with antiplatelet therapy. When choosing the antithrombotic therapy, the key to the antithrombotic therapy of atrial fibrillation combined with coronary atherosclerotic heart disease is to reduce the bleeding risk and achieve the maximum clinical effect. Warfarin, as a traditional anticoagulant for atrial fibrillation, has promoted the rise of new oral anticoagulants (NOAC) due to its own limitations, and there are new choices and understanding of oral anticoagulants in antithrombotic therapy. However, the clinical efficacy and safety of NOAC in patients with atrial fibrillation combined with coronary atherosclerotic heart disease is still controversial. This paper reviews the effectiveness and safety of NOAC applied to antithrombotic therapy in patients with atrial fibrillation combined with coronary atherosclerotic heart disease.