Dual-pathway inhibition for secondary and tertiary antithrombotic prevention in cardiovascular disease

被引：97

作者：

Capodanno, Davide ^{[1
]}

Bhatt, Deepak L. ^{[2
]}

Eikelboom, John W. ^{[3
,4
]}

Fox, Keith A. A. ^{[5
]}

Geisler, Tobias ^{[6
]}

Gibson, C. Michael ^{[7
]}

Ramon Gonzalez-Juanatey, Jose ^{[8
]}

James, Stefan ^{[9
,10
]}

Lopes, Renato D. ^{[11
]}

Mehran, Roxana ^{[12
]}

Montalescot, Gilles ^{[13
]}

Patel, Manesh ^{[11
]}

Steg, P. Gabriel ^{[14
]}

Storey, Robert F. ^{[15
]}

Vranckx, Pascal ^{[16
,17
]}

Weitz, Jeffrey I. ^{[18
,19
,20
,21
]}

Welsh, Robert ^{[22
,23
]}

Zeymer, Uwe ^{[24
,25
]}

Angiolillo, Dominick J. ^{[26
]}

机构：

[1] Univ Catania, Azienda Osped Univ Policlin Vittorio Emanuele, CAST PO G Rodolico, Div Cardiol, Catania, Italy

[2] Harvard Med Sch, Brigham & Womens Hosp, Heart & Vasc Ctr, Boston, MA 02115 USA

[3] Hamilton Gen Hosp, Populat Hlth Res Inst, Hamilton, ON, Canada

[4] McMaster Univ, Hamilton, ON, Canada

[5] Univ Edinburgh, Ctr Cardiovasc Sci, Edinburgh, Midlothian, Scotland

[6] Univ Hosp Tubingen, Dept Cardiol & Angiol, Tubingen, Germany

[7] Harvard Med Sch, Beth Israel Deaconess Med, Dept Med, Cardiovasc Div, Boston, MA 02115 USA

[8] CIBERCV, IDIS, Univ Hosp, Cardiol Dept, Santiago De Compostela, Spain

[9] Uppsala Univ, Dept Med Sci, Uppsala, Sweden

[10] Uppsala Univ, Uppsala Clin Res Ctr, Uppsala, Sweden

[11] Duke Univ, Duke Clin Res Inst, Div Cardiol, Durham, NC USA

[12] Icahn Sch Med Mt Sinai, Cardiovasc Inst, New York, NY 10029 USA

[13] Sorbonne Univ, Pitie Salpetriere Hop, AP HP, ACTION Study Grp,Inst Cardiol, Paris, France

[14] Paris Univ, Hop Bichat, AP HP, FACT,INSERM,U1148, Paris, France

[15] Univ Sheffield, Dept Infect Immun & Cardiovasc Dis, Sheffield, S Yorkshire, England

[16] Univ Hasselt, Hartctr Hasselt, Dept Cardiol & Crit Care Med, Hasselt, Belgium

[17] Univ Hasselt, Fac Med & Life Sci, Hasselt, Belgium

[18] McMaster Univ, Dept Med, Hamilton, ON, Canada

[19] McMaster Univ, Dept Biochem, Hamilton, ON, Canada

[20] McMaster Univ, Dept Biomed Sci, Hamilton, ON, Canada

[21] Thrombosis & Atherosclerosis Res Inst, Hamilton, ON, Canada

[22] Mazankowski Alberta Heart Inst, Cardiac Sci Dept, Edmonton, AB, Canada

[23] Univ Alberta, Edmonton, AB, Canada

[24] Klinikum Ludwigshafen, Ludwigshafen, Germany

[25] Inst Herzinfarktforsch, Ludwigshafen, Germany

[26] Univ Florida, Coll Med, Div Cardiol, Jacksonville, FL USA

来源：

NATURE REVIEWS CARDIOLOGY | 2020年 / 17卷 / 04期

关键词：

ACUTE CORONARY SYNDROMES; FACTOR XA INHIBITOR; PERIPHERAL ARTERIAL-DISEASE; ORAL ANTICOAGULANT-THERAPY; AORTIC-VALVE IMPLANTATION; RIVAROXABAN PLUS ASPIRIN; ANTIPLATELET THERAPY; DOUBLE-BLIND; ATRIAL-FIBRILLATION; MYOCARDIAL-INFARCTION;

D O I：

10.1038/s41569-019-0314-y

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Advances in antiplatelet therapies for patients with cardiovascular disease have improved patient outcomes over time, but the challenge of balancing the risks of ischaemia and bleeding remains substantial. Moreover, many patients with cardiovascular disease have a residual risk of ischaemic events despite receiving antiplatelet therapy. Therefore, novel strategies are needed to prevent clinical events through mechanisms beyond platelet inhibition and with an acceptable associated risk of bleeding. The advent of non-vitamin K antagonist oral anticoagulants, which attenuate fibrin formation by selective inhibition of factor Xa or thrombin, has renewed the interest in dual-pathway inhibition strategies that combine an antiplatelet agent with an anticoagulant drug. In this Review, we highlight the emerging pharmacological rationale and clinical development of dual-pathway inhibition strategies for the prevention of atherothrombotic events in patients with different manifestations of cardiovascular disease, such as coronary artery disease, cerebrovascular disease and peripheral artery disease. Many patients with cardiovascular disease have a residual risk of ischaemic events despite receiving antiplatelet therapy. In this Review, Angiolillo and colleagues discuss the pharmacological rationale and clinical development of dual-pathway inhibition strategies for the prevention of atherothrombotic events in patients with cardiovascular disease.

引用

页码：242 / 257

页数：16

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