Combining Antiplatelets and Anticoagulants Risky合用抗血小板药和抗凝药危险

A prospective study concluded that concomitant antiplatelet therapy (APT) should not be prescribed with an oral anticoagulant in patients with stable coronary artery disease (CAD). The study included 4184 outpatients who were free from any myocardial infarction (MI) or coronary revascularization for >1 year at inclusion. Follow-up was performed at 2 years. Major bleeding events are rare but are an independent predictor of death. The increased risk of bleeding associated with vitamin K antagonist (VKA) treatment was particularly evident when VKA was combined with an APT. In contrast, the risk of cardiovascular death, MI, or nonhemorrhagic stroke did not differ in patients who received VKA + APT versus patients on VKA alone. There is no evidence that inhibition of platelet activation provided anything but harm in patients with atrial fibrillation who did not have CAD. Source: http://content.onlinejacc.org/一项前瞻性研究的结论是，对病情稳定的冠心病（CAD）不应该联合应用抗血小板治疗（APT）与一种口服抗凝药。该研究共纳入4184名〉1年无任何心肌梗死（MI）或冠状动脉血管重建术的门诊病人。 两年时进行了随访。大出血事件很少却是死亡的独立预测因素。当维生素K拮抗剂（VKA）与APT合用时，与VKA治疗相关的出血风险增加尤为明显。与此相反，心血管病死亡，心肌梗死或非出血性卒中的风险在VKA + APT与VKA单独治疗的患者中没有显着差异。没有任何证据表明抑制血小板活化对没有CAD的房颤患者有益，反而有害。来源：http://content.onlinejacc.org/