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Older Adults in the Cardiac Intensive Care Unit: Factoring Geriatric Syndromes in the Management, Prognosis, and Process of Care: A Scientific Statement From the American Heart Association Dabigatran dual therapy with ticagrelor or clopidogrel after percutaneous coronary intervention in atrial fibrillation patients with or without acute coronary syndrome: a subgroup analysis from the RE-DUAL PCI trial A randomized multicentre trial to compare revascularization with optimal medical therapy for the treatment of chronic total coronary occlusions 中国肺高血压诊断和治疗指南2018 Complete Revascularization Versus Culprit Lesion Only in Patients With ST-Segment Elevation Myocardial Infarction and Multivessel Disease: A DANAMI-3-PRIMULTI Cardiac Magnetic Resonance Substudy 2019 AHA/ACC/HRS Focused Update of the 2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society ACCF/SCAI/STS/AATS/AHA/ASNC 2009 Appropriateness Criteria for Coronary Revascularization: A Report by the American College of Cardiology Foundation Appropriateness Criteria Task Force, Society for Cardiovascular Angiography and Interventions, Society of Thoracic Surgeons, American Association for Thoracic Surgery, American Heart Association, and the American Society of Nuclear Cardiology Endorsed by the American Society of Echocardiography, the Heart Failure Society of America, and the Society of Cardiovascular Computed Tomography Microthrombi As A Major Cause of Cardiac Injury in COVID-19: A Pathologic Study Macrophage MST1/2 Disruption Impairs Post-Infarction Cardiac Repair via LTB4 Prevalence of Angina Among Primary Care Patients With Coronary Artery Disease
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JOURNAL：ACC Article Link

房颤合并慢性肾病的抗凝策略

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房颤(Atrial fibrillation， AF)和慢性肾脏疾病( chronic kidney disease ，CKD)的多种致病因素常存在共通性，如高血压、糖尿病和冠状动脉疾病。当不合并CKD时，对房颤患者开展抗凝治疗是毋庸置疑的，但此做法不适用于房颤合并晚期CKD的患者群（advanced CKD）。随着CKD患者肾功能的下降，缺血性卒中和出血的危险逐渐增加，使抗凝治疗趋向复杂。现存随机对照试验尚不能得出可明确辅助临床决策的指南性意见，而观察性研究的结果相互矛盾。在最新JACC综述“Anticoagulation in Concomitant Chronic Kidney Disease and Atrial Fibrillation: JACC Review Topic of the Week”中,作者概述了相关病理生理学机制,总结CKD合并AF的抗凝策略及研究进展， 并就如何在这些患者中使用口服抗凝给出建议。

该文核心要点可参阅CBSMD文献导读“Anticoagulation in Concomitant CKD and AF”。



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