PDF(Pubmed)
Abstract：
Acute coronary syndrome (ACS) is a leading cause of mortality worldwide. Despite optimal antiplatelet therapy recommendation after ischemic events, recurrent thrombotic complications rate remains high. The recurrent events maybe in part due to increased thrombin levels during ACS which may underscore the need for an additional anticoagulation therapy. Given the advantages of non-vitamin K antagonist oral anticoagulants (NOACs) over warfarin, they have the potential to prevent thrombus formation, in the presence or absence of atrial fibrillation, but at the cost of increased risk of bleeding. NOACs have also shown a promising efficacy in managing left ventricular thrombus and a potential benefit in avoiding stent thrombosis after percutaneous coronary revascularization. Taken as a whole, NOACs are increasingly used for off-licence indications, and continue to evolve as essential therapy in preventing and treating thrombotic events. Herein, this review discusses NOACs off-label indications in the setting of ischemic coronary disease.
摘要：
急性冠脉综合征(ACS)是世界范围内死亡的主要原因。尽管在缺血事件后推荐最佳抗血小板治疗，血栓并发症的复发率仍然很高。复发事件可能部分是由于ACS期间凝血酶水平升高，这可能强调需要额外的抗凝治疗。鉴于非维生素K拮抗剂口服抗凝剂（NOAC）优于华法林，它们有可能防止血栓形成，在有或没有心房颤动的情况下，但以增加出血风险为代价。NOAC还显示出在管理左心室血栓方面的有希望的功效和在经皮冠状动脉血运重建后避免支架血栓形成的潜在益处。作为一个整体，NOAC越来越多地用于非许可适应症，并继续发展成为预防和治疗血栓事件的基本疗法。在这里，这篇综述讨论了NOACs在缺血性冠状动脉疾病背景下的标示外适应症。
