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The Wait for High-Sensitivity Troponin Is Over—Proceed Cautiously Impact of the US Food and Drug Administration–Approved Sex-Specific Cutoff Values for High-Sensitivity Cardiac Troponin T to Diagnose Myocardial Infarction Clinical Outcomes Following Intravascular Imaging-Guided Versus Coronary Angiography–Guided Percutaneous Coronary Intervention With Stent Implantation: A Systematic Review and Bayesian Network Meta-Analysis of 31 Studies and 17,882 Patients Good response to tolvaptan shortens hospitalization in patients with congestive heart failure Cardiac Implantable Electronic Devices in Patients With Left Ventricular Assist Systems Revision: prognostic impact of baseline glucose levels in acute myocardial infarction complicated by cardiogenic shock-a substudy of the IABP-SHOCK II-trial Usefulness of longitudinal reconstructed optical coherence tomography images for predicting the need for the reverse wire technique during coronary bifurcation interventions Wearable Cardioverter-Defibrillator after Myocardial Infarction Can We Use the Intrinsic Left Ventricular Delay (QLV) to Optimize the Pacing Configuration for Cardiac Resynchronization Therapy With a Quadripolar Left Ventricular Lead? Use of Risk Assessment Tools to Guide Decision-Making in the Primary Prevention of Atherosclerotic Cardiovascular Disease A Special Report From the American Heart Association and American College of Cardiology

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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,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,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”。