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AHA科学声明：冠状动脉旁路移植术后二级预防

2015-02-11 CMT 医学论坛网

CABG冠状动脉旁路移植术二级预防AHA科学声明
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2月9日，美国心脏学会(AHA)在《循环》(Circulation)杂志上发布了《AHA科学声明：冠状动脉旁路移植术后二级预防》。 AHA科学声明：冠状动脉旁路移植术后二级预防之抗血小板治疗建议、抗栓治疗建议、β受体阻滞剂治疗 先来点击下载文献原文吧： 下载：Secondary Prevention After Coronary Artery Bypass Graft Surgery


2月9日，美国心脏学会(AHA)在《循环》(Circulation)杂志上发布了《AHA科学声明：冠状动脉旁路移植术后二级预防》。

AHA科学声明：冠状动脉旁路移植术后二级预防之抗血小板治疗建议、抗栓治疗建议、β受体阻滞剂治疗

 推荐建议

推荐级别

1、冠状动脉旁路移植（CABG）术前和术后6小时内应该用阿司匹林，推荐剂量为81—325 mg/d，然后继续使用阿司匹林，无明确期限，以减少移植闭塞和不良心脏事件。

1类推荐，A级证据

2、非体外循环CABG(off-pump CABG)术后，应用阿司匹林（81–162 mg /d）联合氯吡格雷（75 mg/ d）的双联抗血小板治疗达1年。

1类推荐，A级证据

3、对于CABG术后因阿司匹林不耐受或者过敏的患者，氯吡格雷（75 mg/ d）是其合理选择，继续无限制使用氯吡格雷是合理的。

IIa类推荐，C级证据

4、对于急性冠脉综合征患者，虽然有关CABG人群的前瞻性临床研究数据尚缺乏，但CABG术后给予其阿司匹林联合普拉格雷或替格瑞洛（首选氯吡格雷）是合理的。

IIa类推荐，B级证据

5、CABG术后进行单一抗血小板治疗，考虑更高剂量的阿司匹林（325 mg /d，而非81 mg/ d）是合理的，大概是为了防止阿司匹林抵抗，但患者获益尚不十分明确。

IIa类推荐，A级证据

6、对于近期无急性冠脉综合征的患者，体外循环CABG(on-pump CABG)术后可考虑给予其1年的阿司匹林联合氯吡格雷双联抗血小板治疗。

IIb类推荐，A级证据


先来点击下载文献原文吧：

下载：Secondary Prevention After Coronary Artery Bypass Graft Surgery

A Scientific Statement From the American Heart Association


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    2015-04-02 AspirantSuo

    #旁路移植术#

    0

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    2015-02-17 chinayinhan

    已阅

    0

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    2015-02-16 windmilL1989

    赞

    0

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    2015-02-15 jianlion

    恩恩

    0

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    2015-02-15 午夜星河

    明白

    0

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    2015-02-13 zhaohui6731

    #AHA#

    0

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    2015-02-13 zhaojie88

    #冠状动脉旁路移植术#

    0

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    2015-02-19 cy0324

    #移植术#

    0

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